New Implant 80% Silicone 20 % Saline

[in love]

I went for a consult yesterday with the doctor that I am definitley going to get my breast augmentation done with. He was very informative and helpful. I told him I wanted 800 cc's, and he said it wouldn't be possible because my frame (chest plate) is only about 13 cm, so it would be physically impossible to get it in. He did however, tell me about a new implant which is 80 % silicone, and there is about 20 % saline in the back of the implant attached to a pump that can actually be pumped with saline after surgery, if i wanted to go bigger.

Im just nervous because this is a new implant and I haven't even heard of anyone having it done, it was just recently passed by the FDA.

Thanks

Rachel

[Dr. Mele]

Dear In Love:

Implants that are both silicone and saline filled have been around for decades. It is not a new concept. They have been around longer than FDA has been approving implants. They consist of a silicone gel filled implant with the ability to add saline. This can be done at the time at surgery or the port can be left in place and adjusted afterwards in the office. Another minor procedure is needed to remove the port.

These implants are not, and have never been FDA approved. The only FDA approved breast implants are single lumen (silicone gel filled or saline filled) made by Allergan and Mentor. The double lumen implants you are considering may have been recently approved for investigation, and then can be used for research purposes as part of a clinical trial. You would need to be enrolled in a clinical trial to use them. You should check the status of the implants yourself with the FDA. Info is available on-line. One well used implant like this was recently recalled, and should not be used because it fails too often. You don't want this one.

These types of implants are used primarily for breast reconstruction. After a mastectomy it is more difficult to match the opposite breast, especially if radiation has been used. In this case the increased risk maybe warranted by the improved result as some tissue expansion can be obtained by the additional volume.

Since there are more parts to these implants, they have had more problems than breast implants with a single lumen. They have an out layer filled with silicone which is not adjustable, and in inner layer that saline can be introduced into to increase the volume. A port is attached to the inner layer and is designed so that when the port is removed the tube can be pulled out. Where the tube is pulled out the implant should self seal. You should discuss this with your doctor. The type were a port is left, and can be filled later, have had problems with leaking at the attachment site. More parts; more problems.

As far as the volume goes. Volume is volume. 800 cc's is 800 cc's no matter how it is delivered. The advantage of the 80/20 implant is that 640 cc's of Silicone filled implant can be placed and then later expanded to 800 cc's. So if 800 cc's is to big for you now because of the dimension of your chest, it will still be too big for you then. But maybe that is what you want.

In the end I think you would be better off picking a size that is appropriate for your frame and and using the simpler less expensive and more reliable single lumen implant. A good guideline for this is checking your breast base diameter against the filled diameter of the final implant. Since implants can only be so close together, the excess width will hang to the side. Judge how much extra there will be and see if you can live with that.

In the end, I have never seen you. I have not had the opportunity to take a medical history or performed a physical examination. I cannot make any recommendation in terms of size or appropriateness of volume. I can only say that while adjustable implants might sound like a great idea, it is not as simple as it seems. If you where my patient, I think I would try to find a simpler way.