“Life in plastic, it’s fantastic”, is one song lyric that might come to mind after reviewing the latest annual plastic surgery report put out by the American Society of Plastic Surgeons. Plastic surgery is here to stay: according to the statistics, there were 15.9 million cosmetic procedures performed in the US in 2015, with breast augmentation crowning the list as the top procedure.
Breast augmentation’s number one spot may be partially attributed to the fact that there are more breast implant options than ever; this year alone Allergan received FDA approval for its Naturelle INSPIRA round and smooth silicone breast implant, and for 28 additional styles of its Naturelle 410 implant – adding on to an already lengthy list of approved implant options to please the most discerning client.
But there is another implant that was made available this year which may suggest that life in plastic, or silicone gel rather, is not the only option for great aesthetics. The Ideal Implant, manufactured by an American implant company of the same name, is a saline implant that was first conceived of over 10 years ago when silicone implants were banned by the FDA in 1992 over health concerns. To provide some context, in terms of breast mimicry, silicone gel implants have always been superior – in fact, many akin saline filled implants to the likeness of a water balloon – but when the FDA banned silicone for use in breast augmentations, saline breast implants were the only option.
The fears surrounding the potential health issues with silicone were sobering – ironically, the founder of the Ideal Implant, Robert Hamas, conceived of the Ideal Implant while observing how the ice in his whiskey sour restricted the movement of the liquid in his glass. He borrowed this concept and developed an implant with internal chambers to keep the saline from spilling around.
Some might say that the Ideal Implant missed its window of opportunity: silicone implants were deemed safe for use in augmentation and reconstruction procedures by the FDA in 2006. In present day, silicone implants dominate the breast implant market again, due to their lifelike feel. Therefore, the Ideal Implant was released into a challenging market – if silicone is safe, why would physicians and patients choose an implant with a potentially sub-par feel at a higher price tag?
This begs the question; is silicone gel truly perceived as safe for long term implantation? In 2014, there were 11 new cases of breast-implant associated anaplastic large cell lymphoma reported in France. While the link between breast implants and this type of lymphoma is not clear, studies suggest that silicone implants may be associated with a specific type of inflammatory response, which may lead to cancer formation. However, breast implant-associated large cell lymphoma is very rare – indeed, only 3 in 100 million women in the US have a chance of being diagnosed per year, which means it is more likely that a patient will be struck by lightning first. However, the FDA concedes that there is a gap in clinical data on this association, as well as an underreporting of this type of cancer.
Therefore, will the Ideal Implant be able to succeed in the US market? It will depend on how motivated patients are to have their implants filled with a biologically-derived substance such as saline. To quote a US plastic surgeon I recently interviewed, “If everything else were equal, would I rather have saline in my body or my patient’s body? Well, sure”. I’m guessing this physician isn’t alone in this statement – which means if the Ideal Implant can prove itself equal to the silicone varieties in terms of aesthetics, it has a good chance of helping many patients live out fantastic – slightly more natural – plastic lives.
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