Adjustable Breast Implants?

Adjustable Breast Implants, Breast Augmentation, Breast Enlargement, Plastic Surgery, Plastic Surgeon NYC, Breast Augmentation by New York Plastic Surgeon Dr Nicholas Vendemia of MAS | 917-703-7069 A recent article in a Chicago newspaper talked about the idea of adjustable breast implants!

This idea isn’t necessarily a new… adjustable breast implants (AKA “tissue expanders”) are used all the time in the first phase of breast cancer reconstruction surgeries. However, the idea of using adjustable implants in cosmetic breast augmentation surgery is relatively new and somewhat controversial.

Continue Reading to learn more about Adjustable Breast Implants!

What are the advantages of Adjustable Breast Implants?

They are adjustable! It’s as simple as that, but unfortunately that may be the only advantage of adjustable breast implants. There is no question that being able to change your mind about the size within a certain amount of time after the surgery is an attractive option.

What are the disadvantages of Adjustable Breast Implants?

They are adjustable! The main advantage of adjustable breast implants is also one of the main disadvantages. In order to adjust the size of the implants, you have to have a filling port placed in a separate area (usually below the implant close to your armpit). A needle is inserted into this port through your skin and allows for saline to be withdrawn or added to change the size. Having this extra port, and having to get a needle stick each time you want a size change, can certainly be a hassle, but simply having the option to change the size whenever you want may be more trouble than it’s worth. If you have an obsessive personality (which we all tend towards after a major life event like surgery), you may find yourself thinking about the size of your implants ALOT! This isn’t necessarily a good thing for you mentally, nor is a good thing for the safety of your implants (see #4 below).
You may require more office visits. Accessing the filling port isn’t something that can be done at home (and shouldn’t!). Every time you want a size change, you’ll have to make an appointment with your plastic surgeon. This may be more of an inconvenience than you think, especially if your surgeon has a large number of patients with adjustable implants who are making appointments at the same time as you.
You will require more surgery. The filling ports need to be removed after 3-6 months. This procedure can be done under local anesthesia, but it’s still another procedure. Sometimes it can be removed through the same incision as your implant was placed, but this may not be your surgeon’s plan. Make sure you ask whether or not you’ll wind up with another scar if your surgeon decides to remove the port through a separate incision.
There may be a higher incidence of infection. Every time you decide to change the size, a needle is introduced through the skin. This is always done as a sterile procedure (or should be!), but it increases the chance of infection nonetheless. In addition, removing the port is also an additional procedure with it’s own inherent risk of infection. While infections are fairly common in the reconstructive setting, they are very uncommon in the cosmetic setting, and we as plastic surgeons want to do everything possible to prevent them. The additional risk that goes along with adjustable implants isn’t necessarily in-line with this goal.
The implants are saline. I believe that silicone implants, especially the newest highly cohesive gel implants (Gummi Bear Implants), are far superior to saline implants in terms of how much more natural they look and feel. Saline breast implants have a higher incidence of wrinkling, rippling, and capsular contracture, and they feel much harder than silicone breast implants. In my mind, saline implants are like driving a Honda, which is fine, but silicone implants are like driving a Rolls Royce! There’s just no comparison…

Are adjustable breast implants for you?

That’s a tough question to answer. The idea of being able to change the size of your breast implants after the surgery really sounds great, but unfortunately the risks might outweigh the benefits. In my opinion, you will be much better off spending time with a plastic surgeon who is truly intent on doing everything possible to help you choose the best size BEFORE surgery.

Here’s how I help my patients choose the perfect size:

We spend a lot of time together. I think this is the most important part of choosing breast implants. The best way to pick the perfect size is to be on the same page with your plastic surgeon, and you can’t possibly be on the same page unless you get to know each other. Your personality helps an experienced breast implant surgeon anticipate “the look” that you’ll be happy with, and it can be quite difficult for he or she to get a feel for your personality during a 15 or 30 minute rushed consultation. I routinely spend 60-90 minutes with breast augmentation patients, and I think it helps us both feel confident in the ultimate size choice.
I take measurements. Measurements are key. The “right size” for you has nothing to do with cup size… it has to do with body size… more specifically, the measurements of your breasts in relation to the rest of your chest. Everyone knows that implants look fake and unnatural if they are too big, but what most women don’t realize is that implants that are too small also look unnatural! The best way to avoid this problem is for your surgeon to take measurements during the consultation and use them to determine an appropriate range of implants to begin choosing from. I always show my patients exactly how I use those measurements to start selecting appropriately sized implants, and we choose the best set of implants together.
We look at sample breast implants. I always show my patients sample breast implants of all different shapes and sizes, and I usually have them place a few sizes in their bra during that visit. This isn’t an extremely accurate way of choosing a size, but it can certainly point us in the right direction, especially when we consider your measurements too.
We look at Before & After photos. A good portion of the my consultation with a breast augmentation patient is always spent looking at photos. It is tremendously helpful for me to know which photos you like and which you don’t. We talk about shape, size, spacing, roundness, fullness, etc etc etc, until we have a small group of your favorite photos. Since I know exactly what size implants I used in all of my Before and After photos, this definitely helps us pin down a size.
We look at photos you like. I always ask my patients to bring in magazine photos that they like. This isn’t so much about the size as it is about the look… I want to know how my patients want to LOOK after surgery… sexy, natural, defined cleavage, close together, big, small.. all of these things are part of “the look” you want. Similar size breast implants can look very different on different body types, so looking at pictures that my patients find attractive is really important in helping me choose an implant that will give them the look they’re after.
We meet several times before the surgery. Let’s face it… sometimes things change. That’s why I always meet a few times with my breast augmentation patients before surgery. The vast majority of the time, we don’t make any major changes in our plan for implant size, but every once in a while a patient will say that they want to go slightly larger or smaller than we initially planned. Even though this happens infrequently, I still believe that it helps us both feel 100% confident that we’re choosing the perfect size.

This system seems to work flawlessly for me and my patients, and I honestly can’t remember the last time one of my patients wished that they had chosen a different size. If you spend time with your surgeon choosing implants before surgery, not only will you save several hours in follow up appointments, the pain of needles during size changes, and a second procedure to remove the port, but you’ll also give yourself piece of mind! If you tend to obsess over things in your everyday life, chances are that you will spend countless hours analyzing your breasts after surgery just because you know you have the option to adjust the size. I think that time could be much better spent enjoying a beautiful new pair of breast implants that were chosen appropriately to begin with!