Dr. Anigian Explains Why the IDEAL IMPLANT® Stands Out from Other Dallas Breast Implants

Ask the patients of Dallas board-certified plastic surgeon Dr. Gregg Anigian why they seek him out and they’ll tell you it’s due to his superior technical excellence, artistic touch, and his ability to make them feel comfortable. We recently sat down with IDEAL IMPLANT® Premier Network Surgeon Dr. Anigian to discuss his private practice, breast augmentation, and IDEAL IMPLANT® Structured Saline Breast Implants.

Tell us a little about what patients can expect when they arrive for an initial consultation.

“When you see me in the office I’ll ask you, and I ask everyone the same question, ‘What can I do for you?’ I won’t tell you what you need to have done, but I’ll really listen to you. You’re coming here and we’re providing a service, and we want that service to be professional. I want you to be pleased with the service that I provide. We want to help our patients achieve their goals and to leave happy with their results.”

Why do you think patients choose your office over the other options they have in the Dallas area?

“I think people understand that we really care about them. I genuinely like people, I like my patients. I want to understand what bothers them, and if it’s surgically possible and technically possible, I want to give them the result that they’re looking for. And I’m very frank with people. My office staff is genuine and friendly. We know the patients’ names, we remember their stories. We’re looking for what makes them happy.”

What procedures do you offer at your private practice in Dallas?

“I believe that being complete and doing a variety of things makes you a stronger surgeon and a better doctor. I offer many cosmetic surgery procedures such as rhinoplasty, liposuction, breast augmentation, body contouring, etc, but a large part of my practice is also dedicated to microsurgical breast reconstruction. That’s a highly technical procedure. The results are extremely dynamic for women who are going through that terrible process in their lives. It is gratifying to me to watch and see how really strong people are inside when they’re faced with that sort of thing. But it’s really remarkable in how the aesthetic side of reconstructing the breast and the reconstructive part of augmenting a breast for cosmetic reasons mesh together.”

When it comes to breast augmentation, how do you help women choose the size and type of breast implant that’s right for them?

“First I’ll ask her, ‘What do you want?’ I’ll do an initial verbal exam. I’ll ask questions like:

Any health problems? Have you had kids? Do you have implants now? Do you have any medical conditions that I need to know about? Then I’ll ask, ‘What would you like to see happen? Are you an A cup and you want to be a C cup? What is your day-to-day lifestyle? Are you a runner? Do you lift weights? Are you planning on a pregnancy in the future?’ All those things are deciding factors.

“My aesthetic preference is that implants shouldn’t look like implants; that the breast should be full and aesthetically pleasing, but I’d like to fool everybody in the room and not necessarily have somebody go, ‘Oh, she got a new set of breasts, bought and paid for.’ I think that used to be okay, I don’t think that’s okay today.

“When determining the size a woman wants, we have a number of bras in the office. So we literally will have a woman put on a brassiere, put a sizer into the bra, and have her wear her top and say, ‘Where are we? Do we need to go larger? Are we right? Are we too small?’ So that works very well. I hardly ever have someone say, ‘Oh, I’m not big enough.’ I can’t remember the last time I had to replace an implant because we got the size wrong. So it is very accurate in helping women determine where they’d like to be.”

How do you go about setting realistic expectations so that women can be satisfied with their outcomes?

“Listening and asking questions is what I do. I’ll ask her, ‘What do you want to see? What do you expect?’ When the expectations that you, the patient wants, and the result that I think I can get mesh together, is when I think we both become comfortable with proceeding.

“I think sensitivity is important. We always talk about that. It is possible to lose sensation. Either in the nipple, areola, or the lower portion of the breast. For me an inframammary incision is the easiest to deal with. I think it’s the safest. That incision line heals so well that it is hard to find when it’s placed in the right position. The size of the chest and the breast really tell me what kind of size implant that is safe to put in.

“If you are terribly thin and very small and narrow, putting in large implants may satisfy you on a certain level but that’s going to be something that you may regret six months to a year from now because all the anatomy of your chest might change. So I tell women often, ‘Remember who you are going to be,’ or, ‘Think about the woman that you’re going to be in ten years. You’re making a decision for that girl as well as the girl that you’re going to be in six months.’ So that sort of push/pull is important in making a decision regarding size, and in having your expectations being met.

“I can’t tell you how many women come in who had their breast implants placed back in the ’80s and they say, ‘I don’t know why he put in such big implants. I wanted to be a C and I walked out a DD.’ That’s a really common story. So we don’t want to have you two cup sizes different than what you thought you were going to be. So using that sizer ahead of time to get an idea of what makes you comfortable gets me really a lot closer to understanding what’s in your head. I think that’s important, and so you also understand what to expect and your expectations are a lot closer to what I can give you.”

What is the difference between a breast augmentation and mastopexy (breast lift)? How can a woman tell which one she needs?

“There are a couple of misconceptions about breast lifts. The breast is obviously the most feminine feature in the torso. It changes over time, and sometimes that happens because of weight gain, weight loss, pregnancy, or just age. One of the things that I’ve found is that after menopause a lot of women’s breasts get bigger instead of smaller. Women don’t know that, they say, ‘Nobody told me that my breasts were going to get bigger, now they’re too big,’ or, ‘They’re the right size, they’re just south of where they need to be and I don’t want to have an implant.”

“A mastopexy can restore not only the position of the breast by lifting it, but it can also add volume in the upper part of the chest, restoring fullness and firmness. You can have a very aesthetic looking breast that survives time. Not just for the next six months, but it really resets the clock so that now you’re aging as if you had a breast that had never fallen in the first place. That’s my own technique. I literally take the breast apart as we would if we were doing a breast reduction, lift the breast tissue up, and create a round breast mound that holds itself to the chest wall. Then the skin which has failed is now not responsible for holding the position of the nipple. Nipple sensitivity is absolutely something that should be maintained. Those two nerves don’t come into play during the lift. A breast lift can also be combined with a small reduction at the time. So if you have a little bit more volume than you need and you want to reduce that, then that can be done as well.

“Women really love it. A breast lift can restore that youthful appearance that a woman may have seen when she was 18 or 25, before the breast began to sort of slide down the body. It narrows the chest, it lengthens the waistline. It gives her a comfort level that she didn’t have before and it then expands the types of clothes that she can buy when shopping. It can really increase confidence.

“People think, ‘It sounds like it’s going to hurt so much,’ but none of the women that have had a breast lift call into my office complaining about the pain. The recovery time is also quicker than you would expect. It is six weeks without being able to do yoga, but it’s only five to eight days before you can start exercising again.”

How did you find out about IDEAL IMPLANT® Structured Breast Implants and how long have you been using them in your practice?

“The inventor of IDEAL IMPLANT is a board-certified plastic surgeon named Robert S Hamas. I’ve known Bob for years. He showed up in my office after giving me a phone call and saying, ‘Gregg, I’ve got something to show you.’ He showed me the first iteration of what was a structured saline implant. It was nothing like what we currently have, but it was an idea and a concept was started.

“So he went back to the lab and then came up with another iteration of it. ‘What do you think about this?’ I said, ‘Well, it’s closer.’ Then he came back again and said, ‘Okay, this is what I think we want to do, would you mind being a co-investigator with me? We need to get FDA approval and the first stage of this is to do a trial.’ So he did ten breast augmentations with the IDEAL IMPLANT and I did ten. We reported the results to the FDA and they said, ‘Okay, you can start the large trial,’ which then was done with 500 women.

“There are women that I have followed for ten years with the original IDEAL IMPLANT. I have more experience than almost any other plastic surgeon using the IDEAL IMPLANT. Once it became FDA approved, I started using it for augmentation purposes.”

Who makes a good candidate for the IDEAL IMPLANT?

“Women that have lost volume in their breasts due to childbearing or just want a fuller appearance in general and are also concerned about safety. I feel that the IDEAL IMPLANT really bridges that gap that we currently have with silicone gel implants. Not that silicone gel implants are dangerous, but they certainly do have their trade offs.

“With all of these breast implant devices, you have to understand that they may break at some point. If they do, which would you rather have inside of you? Salt water that is dissolved in your body, or silicone gel? Would you rather know that your implant is broken or would you rather find out later at your mammogram or MRI? With the IDEAL IMPLANT, women can know immediately that their implant is ruptured, and they have peace of mind knowing it’s just salt water inside. Any woman desiring that peace of mind is a good candidate for the IDEAL IMPLANT.”

How long does it take to replace a ruptured silicone gel implant compared to a ruptured IDEAL IMPLANT?

“If we need to trade out a silicone gel implant it’s a bigger procedure, it’s more involved. I have to take out the silicone gel implant and the surrounding tissue that forms around it called the tissue capsule. Then I have to close the pocket down if necessary and get all the silicone material out and then put in the new silicone or structured saline implant. If an IDEAL IMPLANT breaks, the procedure takes about a third of the time. An IDEAL IMPLANT rupture doesn’t happen as often as a silicone gel implant rupture. It’s simply taking out the old implant and putting in a new one. So that’s a much lesser procedure than taking out ruptured silicone gel implants.

“We have lots of short videos on what broken silicone gel implants look like on their way out. Every time I take one out, it reinforces the idea that the IDEAL IMPLANT is a better alternative, certainly for women that are very young or women that have had silicone for a while and want to change or need to change to a different implant.”

What are the primary reasons women choose the IDEAL IMPLANT in your practice?

“Women want the implant to feel good and they want it to be safe. Now the majority of women can have both. They can have the feel and appearance they want, and they can have safety. Really 80% of the patients that I see can have all of those things without sacrificing anything. An IDEAL IMPLANT and a silicone gel implant are very difficult to tell the difference between in 80% of women. Only in those women who have had either multiple implant surgeries and are extremely thin can I tell the difference.

“Women don’t want to constantly monitor their breast implants. With silicone gel implants you can only check for ruptures with an MRI scan or a 3D resolution mammogram. That is not easy to do. With the IDEAL IMPLANT a woman can look in the mirror and say, ‘Well, my implant is okay.’ which is much easier.”

What kind of common complications can women expect with IDEAL IMPLANT?

“Implants in and of themselves have a list of potential risks. Displacement, size mismatch, deflation, contraction formation. Those things can occur. I tell women that they need to treat this implant as they would a heart valve implant or a hip replacement. Perioperative antibiotics are important in reducing the risk of having problems like hardening around the breast. Deflation with IDEAL IMPLANT is uncommon. The overall eight year deflation rate with an IDEAL IMPLANT is 2.1%. There’s not a silicone gel implant that has reported a better eight year rupture rate than that. And again, if your IDEAL IMPLANT ever does break, it’s salt water on the inside of it. It’s important to have these discussions about safety and long term results, in addition to all the other things that go into this personal decision to make a change in your body.”

What advice would you give another plastic surgeon who is considering using the IDEAL IMPLANT in their practice?

“The implant is reliable. You can use the IDEAL IMPLANT just as you would a silicone gel implant of moderate or high profile. You don’t have to worry about it wrinkling. You don’t have to worry about severe palpability more than you would with a silicone implant. You are placing something that will look good for your patients and also minimize the risk of having long term problems. The implant is not going to move out of position over time. The implant is not going to displace. It looks symmetrical on their chest. I understand that eventually an implant may break 10, 15, 20 years from now. But the risk of rupture is so much lower than with silicone gel implants.”

What kind of patient feedback have you received about the IDEAL IMPLANT?

“It’s fair to say that women who have the IDEAL IMPLANT are at least as happy as women who have silicone gel implants. One of the things that I commonly see in my office is a woman who has elected to have the IDEAL IMPLANT, comes in six months after surgery and she’s got this smile. That smile is the IDEAL IMPLANT smile. I really call it that because she’s thinking, ‘I don’t have to worry about this. I’ve got what I want, it’s the right size. I look great in my swimsuit, and I’m safe.’ That aspect of my job is why I continue to use the IDEAL IMPLANT in my practice.”

Considering breast implants in Dallas, TX? Contact Dr. Anigian today to discuss your options. Simply call (214) 369-0006, or visit www.dallasplasticsurgery.com. Dr. Anigian’s office is located at 8220 Walnut Hill Lane, Suite 108, Dallas, TX 75231. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.