Did you know that there is a new type of breast implant available to those seeking a breast augmentation? Now women don’t have to only choose between saline or silicone gel implants. Dr. Thomas Hubbard, a plastic surgeon located in Virginia Beach, VA, and board-certified by the American Board of Plastic Surgery, discussed in a recent interview the differences and advantages of this new, innovative structured implant: IDEAL IMPLANT® Structured Breast Implants.
Can you describe your practice and primary focus as a plastic surgeon?
“I’ve been in practice for 25 years now. Breast enhancement surgery has been a big interest of mine, and a large portion of my practice throughout my career. I’ve always had an emphasis on breast surgery. I joined a surgeon who developed possibly the most important technique in breast surgery – the ‘no-touch technique.’ I was with him almost six years. And with that technique, I’ve got my capsular contracture rate down one in many hundreds. But that’s not the only important thing with breast surgery, there are many parameters that need to be controlled, adjusted, and it’s all about pleasing the patient and getting what she wants.”
How do you help women beginning the breast augmentation process determine implant size, implant placement, and incision location?
“All of my implants are placed beneath the muscle. The advantages are numerous: lower rate of capsular contracture, quality mammograms, more natural appearance. I think with age it works out better in the long run as well. And then a recent study even showed that women with implants above the muscle, when they get breast cancer, it’s more advanced. There are so, so many advantages to going beneath the muscle.
“Regarding the choice about incision, most of mine are inframammary. I use a sleeve, whether I’m using saline or silicone gel, which helps with the capsular contracture rate being extremely low, but especially with silicone gel since it helps with the smaller incision in the inframammary area.
“For all my 25 years, I’ve been using sizing. We have several sets of sizers in the office, and a staff member spends plenty of time with each woman where she tries on different sizers in a bra with a top on, looking in the mirror, until she finds that look that she’s looking for. Now I tell her, ‘I don’t know whether that’s a Double D or a C. In fact, one company’s D is another company’s C. So, that really doesn’t matter. I want you to be comfortable with that look, you’ll find out later what the cup size is.’ We also have the Vector System 3D Imagery that we use. That’s a big advantage. It helps women preview the result. It’s nice to have the 3D imager because all of the implants, all the brands and types are programmed in. Sizing preoperatively is extremely valuable for getting those proportions that you want.”
How do you help women decide between traditional saline implants, silicone gel implants, and IDEAL IMPLANT® Structured Breast Implants?
“I have found that women choose, some with my help and some based on their friends, they choose an implant type and I really don’t see many regrets with the implant type. Maybe because they’ve made up their mind and they’re going to stick with whatever they’ve decided. Maybe because we have done a very good job of educating them about the pros and cons, and they’ve worked it through.
“There are some women who have made up their mind before they come in. I’m happy to go along with their choice. All my implants are smooth. I’ve never done the textured implants, so I don’t have to worry about the lymphoma that is related to textured implants. So if you want silicone gel, fine. If you want saline, that’s fine.
“Now, there is a sizable portion of women who have not made a decision and I’m happy to provide unbiased information. I tell them there is no implant that’s perfect and then I go on to describe the three types of implants – silicone gel, saline, and the IDEAL IMPLANT® Structured Breast Implant. I talk about the pros and cons of all.
“I had practiced many years before silicone gel implants were available, so there was quite a big change when all the silicone gel became available for women age 22 and older. My experience with saline was so good that I didn’t necessarily go to pushing silicone gel, and I still don’t go to pushing silicone gel. I still feel a woman needs to know the pros and cons of all of them, and I’m not going to tell a woman that she needs to go to silicone gel for sure or saline for sure.
“Now some women are better candidates for silicone gel and some women are better candidates for saline. For example, if there is a woman who is 5’10”, 105 pounds, you can see her ribs with very little breast tissue, she’s a Double A or Triple A, I am actually going to suggest to her silicone gel. She has very little padding, so her whole breast is the implant. But a woman who is even a B or a C, even some As, that have enough tissue, they can enjoy the benefits of saline as well. But they need to make that decision.
“If I were to summarize women who are choosing the IDEAL IMPLANT, I’m going to say I think they get it. They get it because they are looking through a lot of hype, a lot of different opinions on the Internet, and they’re seeing that saline has the same happiness rate as silicone gel. There are some long-term benefits of a saline implant: lower capsular contracture rate, less concern over time, and no need to get MRI scans.
“So, in choosing the IDEAL IMPLANT, they get it. The IDEAL IMPLANT is less likely to get visible rippling. It has a more natural feel. And it’s going to have that extremely low capsular contracture rate, which with saline, one in hundreds and hundreds and hundreds gets capsular contracture.”
What if a woman is concerned about implant rupture or wrinkling?
“If you’re really worried about rupture, if it’s something causing your anxiety, if you’re going to find yourself worrying about the silicone gel and “Should I get the MRI?” or wonder if it’s ruptured, maybe you should be considering saline. And if you’re considering saline, look at the rupture rate of the IDEAL IMPLANT. If the leak rate is a concern to you, the IDEAL IMPLANT leak rate is not even half the rate of other implants. So that is a big advantage of the IDEAL IMPLANT.
“As far as rippling goes, I think rippling rates are greatly exaggerated. If you look at the actual studies on rippling rates, the rate is pretty low unless you’re really, really thin. But if it’s a concern and you’re going the saline route, then look at the benefits of the IDEAL IMPLANT as far as rippling rates go.”
Should a woman be concerned about implant rupture?
“I don’t think women that think it’s not a problem are completely informed about the situation. Yes, you can take a ‘gummy bear’ implant, slice it on a table, and really there doesn’t appear to be anything flowing. But then there is an implant that is under the muscle getting squeezed and smashed and squeezed and smashed all day long with all our daily activities. Things don’t stay that way, so the inside silicone gel does get out.
“And in fact, since very few women actually end up getting the MRI scans, there’s a growing number of plastic surgeons who are recommending that a woman just go ahead and switch out her silicone gel implants at 10 years. At that point you probably have about 8% leak rate and with an 8% leak rate, it’s probably time to switch it out and put new implants in.
“Now with silicone gel implants, you’ve got to think about cost. I do inform women that if they’re choosing the silicone gel route, it’s safe and a good implant, but think of long-term cost with the silicone gel as well. Also, there are many of us who believe that it can lead to a capsular contracture at a later time. Women need to consider that you’re not going to know when you have a rupture. A sign that your implant has had a rupture that could have happened years before, is that your breast has turned firm and hard. That’s a capsular contracture. We do everything we can to avoid a capsular contracture.”
How soon after surgery can women return to their regular exercise routines?
“I feel strongly about some recommendations I make. No exercise for three weeks. Why? This goes back to the capsular contracture rate. We want it one in hundreds and hundreds. We don’t want to see capsular contracture more than every few years. And that’s one, and that’s in my opinion, too many. We want it at almost zero.
“How do you do that? Well, a lot is on the surgeon with the technique. I change my gloves multiple times during surgery. I use a sleeve no matter what I do, and you can go on and on with that.
“After surgery though, some woman bring up that their friend did exercise at a week. Well, but up to three weeks you can have a little bit of bleeding. You may not know about the bleeding, but a little around the implant can increase your rate of capsular contracture. This is an investment for the rest of your life. You want it to go extremely well, so we do need to go three weeks without exercise.”
How do women typically feel about the outcome of their breast augmentation?
“I actually do research on satisfaction rates with breast surgery. This is one of the highest happiness rates of any operation out there. Yes, silicone gel and saline have the same happiness rate. It’s very high. So whether you go with silicone gel or saline, you’re likely going to be quite pleased. The bottom line is you’re probably going to be happy with your choice.”
Do you conduct any other research?
“I’m doing research on controlling the settling of implants. I think there are ways to control the settling of implants. Did you know that when a surgeon puts the implants in, they sit a little high initially? They look a little funny initially, since they sit too high. Then they drop for six to seven months. It’s so out of the control of surgeons as to what happens during that six to seven months. Where they’re going to go is where they’re going to go.”
What should women look for in a plastic surgeon?
“I think she needs to make sure that breast surgery is one of the primary focuses of the surgeon that she’s going to see a consultation with. Reputation is very important as well. That makes a big difference. I would pick a surgeon who is offering saline, silicone gel, and the IDEAL IMPLANT. And why is that? Because all women are different. All women have different goals. Why would a surgeon exclude a class of implants that have the same happiness rate. A surgeon should offer all three implants, because all women are different. Their goals are different, and I think it’s important.”
Considering breast implants in Virginia Beach? Contact Dr. Thomas Hubbard today to discuss your options. Simply call 757-687-1900 or visit www.hubbardplasticsurgery.com. Dr. Hubbard’s office is located at 329 Phillip Avenue, Virginia Beach, VA 23454. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.