¡Doctor, I don't know wich breast implants I want !
We understand you have doubts.
Nowadays we often have so much information, some certain (scientific) and other fake (not serious feedback) that our patients come with the wrong idea.
We have been practicing plastic surgeons for 30 years, dedicated especially to Aesthetic Surgery. 30 years ago, patients would come with no information, they knew what they wanted, we would explain it to them and then do it. Everything was much easier for both doctors and patients. They always came to good professionals. We wish the best for our patients.
Back then there was no internet or social media. The patient came to us because of friends or family who had had good results or heard from other people that had been operated and were satisfied. The information was mouth to mouth, and believe me, it was better.
Now there are many plastic surgeons some with fake titles that practice with less scientific accuracy and more eagerness to win money.
On the other hand, companies, have had and have a commercial war between them to offer the best products, sometimes more affordable but less perfect.
30 years after, the number of breast prosthetics, shapes, sizes, textures, gels, etc have changed making it more difficult to choose the better implant. We even have some patients that have read so much on the internet that they ask for a specific prosthetic, which is not always the correct one.
Which is the best breast prosthesis?
After 30 years the implants are quite the same. All of them are silicone more or less compact. This is the truth.
Have we done much progress in these 30 years?
There has been progress in terms of safety and lifespan, but we have been through different “trends” thinking we were going to make progress. Now we are in a situation in which we believe the older ones were better, but these have been removed as they have caused problems and the anatomic and textured ones which seemed better have also been removed for the same reason.
It is hard to admit but medicine is like this. A new medicine is created, tests are done, it is on the market, it seems panacea, but someone will always have unexpected effects. If they are minor, not frequent and if on the contrary it will help most of the population, it will remain on the market. Yet a new one comes out and then after some time they discover that the old one was better than the new one.
Medicine and surgery are not an exact science like math or physics.
We treat human beings and what is good for you, can be bad for me.
Therefore, we have to evaluate each patient and depending on her silhouette and preferences do what the patient wants and choose the best implant for each case.
Then, which is your advice?
My advice is to be as thorough as possible and know the benefits and damages of breast implants across the World.
Another piece of advice it to attend congresses and scientific debates where problems have been encountered with one or other implants and choose what is recommended internationally.
In recent years 2017, 2018 and 2019 we have attended 4 congresses, national and international congresses, dealing with problems caused by breast implants some with isolated cases others on random population studies.
Adding the information received to my personal experience my advice for my patients and relatives whom I have operated and operate are as follows:
- Change rough implants for smooth ones.
- Do not use anatomic implants
- Place them under the pectoral muscle
- Place them under the submamarian crease
- Use implants which have the most guarantees
Below you will find further information:
1 – Smooth better than rough
A new type of lymphoma has been discovered associated to rough implants, especially American ones. It is called Large Cell Anaplastic Lymphoma (LCAL). This is for me a good enough reason not to use these types of implants.
2 – Do not use anatomic implants
These were invented to place, especially under the major pectoral to reduce possible shiftings when moving the arms. They were perfect but there are 2 major problems: one, they are always texturized and two they rotate and cause soreness to many patients whom end up changing them to round and submuscular implants.
By placing the round submuscular implants the muscle puts pressure on the top part and the result is the same as with the anatomic prosthesis without having possible rotation or texturizing.
3 – Under the pectoral musccle
Much nicer to touch, it gives a nicer shape to the breast and there is less of a risk in getting a contracture. When the patient wants a natural or anatomic shape for her breast, we advice a smooth round prothesis with a low or moderate profile. The pectoral muscle usually exerts more pressure on the superior part so it makes the shape of the breast look totally anatomic, but without the mentioned risks.
When the patient wants a round breast with a push-up effect then we advice placing them over or under the muscle but with a high or extra-high profile.
4 – Submamarian crease
In the USA, breast implants are always placed this way and directly under the pectoral in order not to touch the mamarian gland.
In Europe, it is allowed through the areola, but there can be a risk in future reading of mammary scans due to finding scars or unknown bodies (stitches that have not been reabsorbed or that have formed a cyst) therefore it is better not to touch the breast if possible.
5 – Which implants?
Nowadys which are better: high maintenance German cars (Porsche, Mercedes, BMW, Volkswagen, Audi, …), English cars (Bentley, Jaguar, Aston Martin, Rolls Royce,…), Italian cars (Maserati, Lamborghini,…)
Breast prothesis here in Europe are submitted to such an exhaustive sanitary control that all are as good.
However, not all companies have the same warranties of a possible contracture, deformity, rupture, etc. So, here at Clínica Sanza we always work with those that give the most warranties to patients, if possible, of a lifetime warranty for rupture, contracture or deformity.