David F. Pratt, MD

Your photos look very typical of what I see when my early post-op patients come in for their follow-up visits.  At this point, the patient needs a great deal of reassurance that it is normal and expected.  I like to warn my patients before surgery that this will happen, so they will be prepared and not be completely surprised as you appear to be.  I used to worry about it as well, often using a compression band over the top of the implants, hoping to help encourage the implants to move south.  However, I no longer us these bands and have found no difference in my outcomes.  In fact, a more common problem with breast implants is that the implants continue to migrate downward and bottom out.  This can be prevented by wearing a firm, supportive bra the majority of the time that the patient is upright during the healing process.

I hope that I have eased your mind a bit.  Good Luck!

I always make sure I tell my patients and their family members that, although the implants looked great on the OR table, they are going to look “Horrible” the next day- rising all the way up to the collarbone.  This is normal with all types of breast implants and results from the elasticity of the soft tissues of the lower chest and post-operative spasm of the pectoralis muscle, both of which push the implant into the upper reaches of the pocket.  Over the first couple of weeks, the pain slowly begins to resolve and the implants will gradually drop to a more reasonable position, but will continue to look funny for approximately 3 months.  Between 3 and 6 months after surgery, the tissues will have stretched enough for the implants settle down into their pockets, and the firmness and shininess will slowly resolve.  Between 6 and 12 months, they will soften up and take on the consistency and feel of normal breast tissue.

I hope that I have answered your questions satisfactorily.  Good Luck!

“Gummy Bear” implants are highly cohesive Silicone gel implants, meaning that they are essentially solid molds of a rubbery type material, which in my opinion produces a breast with a consistency that is firmer than normal breast tissue.  Since these are Silicone implants, the FDA recommends rupture surveillance every 2 years with MRI exams to monitor for “silent rupture” of the implant.  This the main drawback of the gel implants.  “Gummy Bear” implants require a larger incision and can be fractured during implantation if a small incision is used. 

The Ideal Implant is a new revolutionary design in breast implants, that consists of a “structured” design which gives increased integrity of the anterior shell. This feature allows the implant to resist folding, rippling and caving, which are more prominent with traditional saline breast implants.  These new implants have a consistency that is similar to Silicone gel implants, however, because they are filled with saline, they do not require rupture surveillance. In the unlikely event that the Ideal Implants do rupture, only harmless saline solution is released and absorbed by the body with no adverse consequences.

I hope that I have answered your questions satisfactorily.  Good Luck!

I have been using Ideal Implants for breast augmentation for over a year now and have been quite pleased with the results.  They appear and feel as natural as gel implants and represent an excellent alternative to the Silicone or Saline breast implants. 

The secret is in the design of these implants, which have a double lumen and inner baffles which serve to dampen the motion of the saline fill- creating a soft, natural, flowing implant.  Also, since the Ideal Implant is a “structured” implant design, they tend to resist the natural tendency of an implant to ripple and cave in the superior pole. 

The teardrop implants tend to rotate in the pocket, which requires re-operation to correct.  Also, they only come in a textured surface, which is generally thicker and less natural feeling.  Finally, textured implants are also associated with increased infection rates and the rare Breast Implant Associated Non-Hodgkin’s Lymphoma.

I hope that I have answered your questions satisfactorily.  Good Luck!

Ideal Implants are a good choice for a lean patient such as yourself, since they have a “structured” design, which means the outer shell is more resistant to visible caving and rippling than the shell of a traditional saline implant.  I would most likely recommend that you go submuscular in order to give better coverage of the upper portion of the implant which is the area most likely to have visible irregularities.  Another important point is to not use an excessively large implant, which will tend to stretch out and thin the overlying soft tissues and skin, leading to a higher likelihood of contour problems.

I hope that I have answered your questions satisfactorily.  Good Luck!

The cost for Ideal Implants in the Seattle/Bellevue area is between $8400 and $9000.

These implants are approximately $1000 more than saline implants.

Good luck!

All surgeons have their own opinion regarding what type of breast implant is appropriate for any particular patient.  It is important for your surgeon to be thoroughly familiar and comfortable with whatever implant they are planning to use.  It sounds like the surgeon you saw in consultation was not familiar with the Ideal Implant, thus, they are probably not the best choice for using this type of implant.  You can certainly discuss this issue with them and see what their thoughts are regarding the Ideal Implant. 

My best advice would be to seek out a surgeon who is Board Certified by the American Board of Plastic Surgery and who has extensive experience with Ideal Implants.

I hope that I have answered your questions satisfactorily.  Good Luck!

One of the disadvantages of the Ideal Implant is, currently, they are only available in a high-profile.  This means that patients like you who want a modest increase in breast size are not ideal candidates for the Ideal Implant.  Depending on the patients and their body style, sometimes a narrower Ideal Implant can be used in order to produce the size breast that the patient desires.  However, sometimes this is not possible, leaving only saline or silicone implants as viable options.

I hope that I have answered your questions satisfactorily.  Good Luck!

Currently, for a surgeon to be able to obtain and use Ideal Implants, they must be either Board Certified or Board Eligible by the American Board of Plastic Surgeons.  Additionally, they are required to familiarize themselves with the Ideal Implant literature, since these implants have two filler ports and a unique implant filling protocol when compared to a traditional saline breast implant. 

I would suggest you seek out a local Board Certified Plastic Surgeon who is experienced in using Ideal Implants, instead of trying to coerce a surgeon who is not ready to use Ideal Implants.

Luckily for you, Ideal Implants can be placed in an 18-year-old women.  The FDA requires patients to be at least 22 years old before they can have Silicone gel implants (including “Gummy Bear” or highly cohesive silicone implants), so you are not currently a candidate for a Silicone implant.

I hope that I have answered your questions satisfactorily.  Good Luck!

I don’t routinely recommend that patients massage their implants following breast augmentation.  I feel that it may increase the incidence of bleeding into the pocket, which can lead to a thick layer of scar tissue around the implant (capsular contracture) which will result in a firm, uncomfortable, and immobile breast.  I see my patients back regularly after surgery and carefully evaluate them for any evidence of early capsular contracture.  If the implant(s) appear to be firming up, at that point I will have the patient begin a massage regimen in order to thin out the scar tissue, resulting in a nice soft implant.  My routine is the same for all types of implants, including Ideal Implants.

I hope that I have answered your questions satisfactorily.  Good Luck!