New Breast Implant Choices for Women

Recently, The Plastic Surgery Channel sat down with Dr. Patricia McGuire, a board certified plastic surgeon and a principal investigator for the newly approved 410 form stable breast implant manufactured by Allergan, Inc. We asked her to discuss the confusion among the media and the consumer regarding breast implants and the different choices now available to patients. Below is our interview…

By Patricia McGuire, MD
and Carolynn Grimes
ThePlasticSurgeryChannel.com

PSC- There’s a lot of terms being tossed around referring to breast implants. Terms such as gummy bear, highly cohesive, silicone gel; just to name a few. Can you go through the legitimate terminology for us and explain the differences between the implants?

McGuire– “There are three main types of breast implants available for patients wanting breast augmentation or breast revision surgery.”

• Saline implants are a silicone shell filled with IV fluid.
• Round silicone gel implants are a silicone shell filled with silicone gel. These implants do not hold their round shape.
• Shaped highly cohesive or form stable silicone implants are also a silicone shell filled with silicone gel. The difference is in the consistency of the gel. These implants are a little bit firmer in texture like the gummy bear candy, which holds its shape even when cut into.

PSC- What are the disadvantages of the highly cohesive/form stable gel implant?

McGuire– “Because this implant is a shaped implant it’s placed in the body in a specific position—if that implant moved, it could distort the appearance of the breast. Studies show that doesn’t happen very often, only about 2 to 3 percent of the time, but it can happen. Whereas  if a round implant moved in the breast pocket, there’s no change. The other disadvantage is because it’s a firmer gel, you do need a little bit bigger incision.”

PSC- “But does it have a more natural looking shape?”

McGuire– “You can get a natural looking breast with any type of an implant depending on the size of the implant and the fill of the implant. These give a more teardrop shape. Patients who want a round “bay-watch” type breast will not get that from this implant.”

PSC- “Do you take each case on an individual basis?”

McGuire- “Yes, each patient is different. The advantage of having different implants is we don’t have to make the patient fit the implant, we can pick an implant to fit that specific patient.”

PSC- “The FDA recently approved another implant made by Sientra.  Where does Sientra fit in?”

McGuire- “The Sientra implant is a shaped implant with a high strength gel. It’s more cohesive than the round implants and is a shaped implant. It can be a very useful implant in patients considering breast augmentation and revision.”

PSC- “What do patients who are considering breast augmentation or revision need to know?”

McGuire- “They need to know to go to a board certified plastic surgeon who is experienced in breast augmentation with all types of implants.”

PSC- “What do surgeons need to know about these new form stable implants?”

McGuire- “For surgeons who have not had experience with the shaped implants, they need to get educated because there are some differences.  Making a larger incision then they’re used to, and making the pocket fit around the implant so that the implant is less likely to move.  Also, we don’t have the patients do the displacement exercises—pushing the implants around, because we don’t want to expand the sides of the pocket. These implants also come in different shapes, widths, and projections, which can be very useful if you have a patient with some asymmetries to get a closer match between their breast shape.”

About Dr. Patricia McGuire, MD

Dr. Pat McGuire is a board certified plastic surgeon and clinical instructor of surgery at Washington University School of Medicine in St. Louis, Missouri.  She specializes in cosmetic and reconstructive surgery of the breast, including augmentation, reduction, and lifts, and cancer reconstruction. Dr. McGuire is a clinical investigator for Allergan’s Style 410 highly cohesive (gummy bear) implant.