Zachary Farris, MD, FACS, a cosmetic plastic surgeon in Dallas, Texas, talks about a new development in breast implants that’s combining safety and comfort.
Interview conducted by Ivanhoe Broadcast News in July 2016.
Tell us a little bit about your practice, is it cosmetics and face and body contouring and things like that?
Dr. Farris: The practice we have here is primarily cosmetic plastic surgery and it basically deals with everything with cosmetic surgery pertaining to the face, breast, body and also nonsurgical options.
Today we’re going to talk about breast augmentation and we’re also going to talk about some new options. There’s a new option you’re excited about, let’s talk about that new option. What is it and what’s good about it?
Dr. Farris: The latest implant option for breast augmentation is the Ideal Implant. This is the newest FDA approved breast implant. It’s basically a structured breast implant that feels natural like a silicone implant however it gives you the reassurance of being filled with saline. Unlike silicone breast implants where there’s a small risk of silent rupture and the FDA recommends getting an MRI every couple of years, you don’t have to worry about that with these saline implants.
Would you call it a breakthrough or an advancement?
Dr. Farris: It’s more of an advancement and improvement on what we already have. It’s certainly superior to the old saline implants that we’ve been using which have been essentially water balloons placed inside a woman’s breast. Now with the Ideal Implant, it feels a lot more natural. At the same time, women have the reassurance of it being a saline implant.
When did breast augmentation first start—how long has it been around? Fifty years or more?
Dr. Farris: Plastic surgeons have been doing breast augmentations for a long time now since the 1960s and there’ve been many multiple generations of breast implants with an evolution and improvement on the technology. Nowadays a lot of the breast implants used are silicone and we also have saline implants. They are both safe and effective. It’s just a matter of now we have a new option available for women who are interested in breast augmentation.
What would you say are the advantages or the improvements, what makes this a better option for some women?
Dr. Farris: Based on its unique design, the Ideal Implant, which is composed of multiple shells and two chambers of saline, reduces the issues of bouncing, rippling and the sloshing that you typically have with the old saline implants. Also, its unique design allows the implant to maintain its contour really well. It has low edges so it fits a lot better onto the chest wall. Also if you hold the implant upright, the upper portion of the implant doesn’t collapse as many other implants do.
The other two types you mentioned are approved and safe but there have been problems. What have been the issues first with the original saline implants?
Dr. Farris: The downside to the old original saline implants is they are basically water balloons. They don’t have the natural feel as silicone implants and there’s a lot more rippling. Women are not as satisfied with the feel of those implants in comparison to silicone implants. Now we have the Ideal Implant, which is the newest version of the saline implant but feels a lot more natural and provides more structural form.
With the old saline implants, what kind of complications would arise? Would you have to have further surgery or checkup or anything like that?
Dr. Farris: The main issues with the old saline implants are basically, aesthetically speaking. It’s not as good in terms of its feel compared to silicone implants and has a higher tendency for rippling.
What about leakage?
Dr. Farris: There’s always a risk of deflation or rupture when you’re talking about breast implants as well as capsular contracture. These are potential issues whenever you have breast implants. Breast implants are not meant to last forever so there’s always a possibility that some time down the line you may have to have a replacement or a revision surgery.
Would that be true of all three types?
Dr. Farris: Yes, that’s a concern with all types of breast implants.
This new type does not diminish the possibility of something down the road?
Dr. Farris: There’s always a risk but it may be lower with the Ideal Implant. Based on the Ideal Implant clinical trial of about five hundred patients with a follow up of about five years, the patient satisfaction rate is nearly ninety five percent and the deflation rate is far superior to the other implant makers being under two percent. In addition, the capsular contraction rate is lower than the other implant makers as well.
What does that mean?
Dr. Farris: Capsular contracture is a potential complication whenever you have breast implants. Basically, when you have a foreign object placed inside your body, your body forms scar tissue around that object. Occasionally that scarring can get tight or thick and lead to deformity and discomfort. In this case with breast implants, we call it capsular contracture.
That’s less in these new Ideal Implants?
Dr. Farris: With the new Ideal Implants, there’s a lower rate of capsular contracture compared to the other types of implants.
I guess the type of implant that has been most popular is the silicone?
Dr, Farris: Yes, for the most part many women receive silicone breast implants these days. That’s because they feel very natural and soft. So for most women, they choose silicone breast implants over the old style saline implants.
What are the drawbacks to silicone implants?
Dr. Farris: Occasionally, they may rupture and you may not know about it. In this case, you wouldn’t be able to tell simply by looking in the mirror. In addition, rupture may not be clinically detectable on exam. In this situation, we would call it a “silent rupture.” That’s a small risk but enough for the FDA to recommend that women with silicone breast implants get MRIs every couple of years to rule out these silent ruptures. This is something that you don’t have to worry about with saline breast implants.
Why do they recommend a MRI, what is the concern if there is some kind of a rupture?
Dr. Farris: If you have a rupture with a silicone breast implant, the thick silicone material would be in direct contact with your tissue. That could lead to complications like silicone granulomas, inflammation, capsular contracture and future deformity. It can make revision surgery that much more difficult.
Are these Ideal Implants pretty new?
Dr. Farris: The Ideal Implants are new and are made in the USA, with company headquarters based in Dallas, Texas. The implants were FDA approved in 2014 and became available for use in late 2015.
This is a new option.
Dr. Farris: This is a new option for breast augmentation.
Would you say it’s a better option?
Dr. Farris: It depends on what you want. It’s an excellent option for women to consider especially if they want saline breast implants.
Why would they want saline as opposed to silicone?
Dr. Farris: Some women don’t want to deal with the potential issues of silicone in direct contact with their tissue if there was a rupture. If there were a deflation with a saline implant, the saline or salt water would be safely re-absorbed by the body. Women would know if there was a deflation immediately and there’s no need for any imaging study to evaluate that further. Also, saline implants can be placed in the breasts through smaller incisions because they are not pre-filled like silicone implants.
In your practice, are you offering the Ideal Implant? Are you getting takers?
Dr. Farris: When women come in for breast augmentation, I offer them all the different options in terms of breast implants including the Ideal Implant. I go over the pros, the cons and the risks of each option. At the end of the day, they can make an informed decision about the type of implant they prefer. Today, the Ideal Implant is an excellent additional choice available for patients. Recently, I’ve found that my patients are increasingly interested in this implant. The Ideal Implant is available only through a national network of board-certified plastic surgeons.
You’re seeing a lot of interest in this option?
Dr. Farris: I’m seeing increasing interest from my patients for the Ideal Implant for breast augmentation.
How many of them have you done so far?
Dr. Farris: The implants became available in late 2015 and I’ve done a steady amount since then and have found that the feedback has been really good in terms of how they feel and appearance. Patients have been quite satisfied with these new implants.
What are the most common reasons that women want breast augmentation?
Dr. Farris: Common reasons for why women want breast augmentation is that they have small breasts and would like to go bigger. Many women also want to have more upper pull fullness and improved cleavage.
If some women who are really large they may want reductions too right?
Dr. Farris: Absolutely.
Does that involve an implant or just removing tissue?
Dr. Farris: For women who want to have smaller breasts, they can have a breast reduction and that process does not typically involve the use of breast implants.
You mentioned cleavage, which seems to be an important current factor?
Dr. Farris: Women are increasingly looking to enhance their breasts, which includes improving cleavage. However I think there’s a trend now not to be too big but just a little more natural in appearance; to have more upper pull fullness and cleavage but not look too obvious at the same time.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
If you would like more information, please contact:
Zachary Farris, MD, FACS
214-363-1073
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