The IDEAL IMPLANT® Structured Breast Implant gives you the natural feel you want, but without silicone gel. Although it is filled with only saline for your peace of mind, the breast implant has a natural feel because of its internal supporting structure that controls movement of the saline.
If the IDEAL IMPLANT ruptures, the saline inside is harmlessly absorbed by the body. In addition, you have the confidence of knowing that your implants are intact just by looking in the mirror. In contrast, if a silicone gel implant ruptures, it is “silent” and cannot be detected by looking in the mirror. Current silicone gel implants have been shown to have a high rate of rupture based on MRI scans.
Women have wanted a new type of breast implant – one that would combine the natural feel of a silicone gel implant with only saline inside for safety and peace of mind. After years of research, engineering, product development and a large US clinical trial, the IDEAL IMPLANT was approved by FDA and Health Canada, and is now available through a limited network of board certified or eligible plastic surgeons.
The IDEAL IMPLANT has been in clinical use since February 2009, at the start of the clinical trial. By February 2010, 502 women received the IDEAL IMPLANT from 45 board certified plastic surgeon investigators nationwide. In clinical follow-up over five years, patient and surgeon satisfaction with the outcome has been high and the capsule contracture rate has been low.
Breast Implant Frequently Asked Questions
Choosing Your Breast Implant Size
At your initial consultation, Dr. Rosenthal will measure your breasts and based on that recommend a range of implant sizes that would be appropriate for your breast and body proportions.
Before your first consultation, you may find it useful to browse through Dr. Rosenthal’s “Before and After” photo gallery and take note of women who share a similar body size as you.
At the time of your preop appointment, you will have a “sizing” during which you will be able to take as much time as you need to “try on” different implant types and sizes until you feel comfortable with your size selection. Dr. Rosenthal and staff will assist you in this based on your measurements and your individual preferences. Finding the best size together will result in that great, balanced, and proportional figure you’re seeking.
Choosing Silicone Gel or Saline Implants
For breast augmentation, Dr. Rosenthal inserts silicone gel filled or saline (salt water filled) implants either partially beneath the chest wall muscle or over the chest wall muscle (subglandular) depending on the patient’s individual needs.
Patients will have the opportunity to choose whether they want silicone gel or saline breast implants. The advantage of silicone gel implants is that many people think they feel and look more like a natural breast. They tend to have less potential for visible or palpable ripping than saline implants. One disadvantage of silicone gel implants is that the incision for insertion of the implant may have to be made slightly longer to accommodate the pre-filled implant.
Another issue to consider with silicone gel implants is that, unlike saline implants, they will not deflate when ruptured so a rupture will not be immediately apparent. For this reason, the FDA recommends that women with silicone gel implants undergo an MRI of the breasts three years after implantation and every two years thereafter to check for rupture of the implant.
The advantage of saline-filled breast implants is that if they rupture, the implant will deflate either partially or completely. Then it will be obvious to the woman and her physician that her implant has ruptured. Another positive aspect of saline implants is that implants of a particular size can be variably inflated to correct small differences in symmetry between the breasts. Finally, because saline implants are deflated prior to insertion and are inflated inside the breast pocket that has been created to accommodate them, the incision can be smaller than with a silicone gel filled implant. At your consultation Dr. Rosenthal will assist you in selecting the proper implant type for you.
Choosing an Incision Site
There are three options a woman has for an incision site through which to place the implant. The transaxillary (underarm) incision is about one inch in length and is placed within a high crease in the underarm. The advantage of this incision is that it is well camouflaged high in the armpit. On the other hand, if another surgery on the breasts is needed in the future, another incision under the breast fold or around the areola may be necessary. Because they are deflated prior to insertion, saline implants are ideal for this incision.
The second type of incision is at the inframammary fold underneath the breast. This is probably the best for the silicone gel implants because they are fully inflated prior to insertion and must be placed through a somewhat larger (1 ¾’ – 2’) incision.
The periareola incision (around the lower border of the areola) has been quite popular in the past because it is camouflaged well by the color difference between the darker areolar skin and the lighter breast skin. Recently however, plastic surgery research has indicated that implants placed through this incision may be exposed to small amounts of bacterial contamination (called “biofilm”) when the implant comes in contact with the breast ducts to the nipple, which harbor bacteria. This may result in a slightly higher rate of capsular contracture (hard scar forming around the implant) than when the implant is placed through the other incisions. Less commonly, trans-nipple and transumbilical incisions have been used. The FDA has discouraged the use of the transumbilical incision (which can only be used for saline implants) since there may be a potential for damage to the implant while inserting it through the long tunnel between the umbilicus and breast pocket. At your consultation, Dr. Rosenthal will assist you in selecting the right incision for you.
Breast Augmentation – Subpectoral (Submuscular) or Subglandular Placement of the Breast Implant?
Silicone gel and saline breast implants can be placed under the chest wall muscle (subpectoral, submuscular), or above the muscle but below the breast gland (subglandular). The advantages of submuscular placement are:
- More soft tissue coverage over the implant to prevent visible or palpable rippling.
- Minimize capsular contracture (hardening of breast caused by scar tissue around implant)
- More effective evaluation of mammograms since the muscle separates the implant from the breast gland.
The disadvantages of putting the implant under the muscle include:
- More discomfort for about a week postoperatively.
- Momentary movement of the implant upwards, sometimes with momentary “indentation” of the implant while muscle flexion is occurring while working out. This is usually not visible while the woman is clothed.
The advantages of subglandular implant placement are:
- Less discomfort in the immediate postoperative period with less muscle spasm.
- No movement of the implant when the woman flexes her pectoral muscles.
- May have a better cosmetic appearance in women whose breasts are slightly droopy, but not enough to require a breast lift.
The disadvantages of subglandular placement are:
- May have a higher rate of capsular contracture
- High possibility of visible or palpable rippling since there is less soft tissue coverage over the implant.
- Evaluation of the mammograms may be more difficult because the implant is just below the breast gland, not separated from it by the muscle.
Breast Augmentation – Form-Stable (“Gummy Bear”) Shaped Implants
In recent years the FDA has approved the use of form-stable or “Gummy Bear” implants for breast augmentation. These implants are silicone gel-filled, have a textured outer shell, and are produced in various shapes to simulate natural appearing breast contours. These breast implants contain highly cohesive silicone gel. This means that if they rupture, very little silicone gel will extrude from the implant. Form stable implants tend to be somewhat firmer than round silicone gel implants (which may also contain cohesive gel but sometimes to a lesser degree). All form-stable silicone gel implants have a textured surface so they “stick” to the surrounding tissue to maintain the right position and breast shape.
At your consultation you will have the opportunity to see and feel different implant types. Dr. Rosenthal will assist you in selecting your most desirable implant type for your breast enlargement.
Should I Get Smooth or Textured Breast Implants?
Both saline and silicone gel implants can have a smooth or textured (rough surfaced) firm silicone outer shell. There is some research that suggests that patients with textured silicone gel implants may have a somewhat lower chance of capsular contracture (hardening of the breasts due to scar tissue). On the other hand, because they tend to “stick” to the overlying tissue there may be a slightly higher chance of visible or palpable rippling with textured implants. Smooth-surfaced implants will move within the breast pocket, while textured breast implants are likely to stay in one position.
Shaped breast implants are necessarily textured to keep the implant in the desired orientation for a particular shape.
Are Breast Implants Permanent?
A rule of thumb is to expect 10 years for your implants to last. That isn’t a hard and fast rule, as they can last longer or shorter than that. Implants will eventually rupture and this is the time to have them removed and replaced. Implant durability is continually improving, so longevity should continue to increase.
Can Breast Implants Cause Cancer?
There is no direct evidence of breast implants causing breast cancer. There was some news in 2017 potentially linking breast implants and the development of anaplastic large cell lymphoma (ALCL), a rare cancer of the immune system. However, the FDA didn’t say that implants cause ALCL, only that there is an “association.” The risk of this appears extremely low, and the cure rate is over 90 percent, so it is important to keep things in perspective.
There hasn’t been any evidence that breast implants cause breast cancer.
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