Adjustable Breast Implants?

There is a new weapon in the war against small breasts – a breast implant that has adjustable volume. Adjustable breast implants have a port through which saline can be added or removed. This allows the volume to be adjusted for various reasons. Before you get too excited, these are not intended to allow women to increase their breast size for a night on the town, or decrease the size for that important business meeting. The adjustment process involves a plastic surgeon placing a sterile needle through the skin into the fill port that is under the skin and meticulously adding or removing sterile saline solution. So it is a far cry from the Reebok Pump sneaker technology of the Eighties.

So why the need for this adjustable implant? There are 3 situations in which I would use these adjustable implants in my breast practice:

1. To account for pre-operative differences in the shape and volume of the breasts. Breast asymmetry is very common and can make it difficult to choose the appropriately sized breast implants. A post-operative adjustable implant allows the surgeon to make small adjustments in the breast volume for months after the surgery, allowing better matching between asymmetric breasts.

2. To correct breast deformities such as Tuberous Breasts. Tuberous Breast Deformity is a fairly common condition characterized by an underdeveloped breast that is constricted at its base. Correction of this deformity involves placing a breast implant to increase the size (this is often only on one breast) and to correct the constricted base of the breast. Unfortunately, this cannot be done simply by placing a breast implant. You actually need to stretch the base of the breast. A post operative adjustable breast implant allows the gradual expansion of the base of the breast to improve the shape and size.

3. To help women choose a breast size that they are happy with. The most common reason for breast implant reoperation is for a change in size. Some reports find that 25% of women ultimately undergo reoperation simply to increase/decrease the size of the implant. A post operative adjustable implant allows the surgeon to place the implant to the desired volume and then over the next several months, small adjustments can be made until the woman is certain of the size.

While this may make these implants sound like the best thing since sliced bread, there are some drawbacks.

• The implants are only saline, which have a tendency to be more visible, more palpable, show rippling and be more “unnatural” than their silicone cousins.
• Adjusting the volume of the implant involves a visit to the doctor and a needle in the skin, which can cause pain and does carry some risk of infection.
• The fill port is palpable under the skin and may feel like a marble.
• Removal of the fill port involves a small office procedure.
• The range of each implant is limited (usually about 75cc in each direction) so you still need a basic idea of what size range you would like.

In my practice, 80% of the breast implants that I place today are silicone because I feel that these are the most natural appearing (and feeling) implants. I do occasionally use adjustable implants though for the situations that I outlined above. In the right circumstance, these implants are a powerful weapon in the field of breast surgery, especially in cases of marked breast asymmetry or congenital deformities. Please feel free to Contact my office if you have any questions about adjustable breast implants or if you would like to schedule a consultation.

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