Motiva round textured 265cc. Height 163, weight 43 kg thin

Question

Hi, Doctor suggested motiva textured round implant of 265cc. Incision using funnel tech at armpit. Implant placed over the muscle. He mention that latest motiva have more layers and so its harder for capsular contracture to occur. I would like to ask if the overall diagnosis is agreeable . Doctor did also mention that it is not advisable for me to go above 265cc as i was quite thin. Lastly, i am thinking of reporting to work 1 week later . Will it be fine to do so?

Christopher V. Pelletiere, MD · Answer

If your surgeon is using Motiva implants at this point, then I would be very wary.  Motiva has not even entered the FDA process yet for approval of their implants.  This usually takes three years of studying the implants in the US and then presenting the data to the FDA.  They hope to start this process in mid-2017.  If your surgeon is using them, that means they are being bought overseas and brought in against the FDA.  I would go for a few more consultations with board certified plastic surgeons since implanting a device that is not even FDA approved could have warranty issues over time.  They may be great implants, but until the FDA gives them clearance to even be trialed in the US, I would use one of the other manufacturers.  I hope this helps.

John Zavell, MD, FACS · Answer

Motiva implants are made by a South American company called Establishment Labs and have not received FDA approval.  Although surgeons in the U.S. can obtain the implants, these implants have not yet met the strict FDA approval process to determine their safety.  I would question your surgeon as to why he/she prefers these implants and not FDA approved choices such as Mentor, Allergan, or Sientra implants.  You may benefit from a second opinion from a board-certified plastic surgeon.  Good luck.

Tom J. Pousti, MD · Answer

Thank you for the question. There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well. I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.    Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals.

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as  “natural” or "C or D cup”  etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery,  after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast  augmentation surgery concerns) helps.  Best wishes.

Victor Ferrari, MD, FACS · Answer

First, Motiva implants are FDA cleared (which means the FDA recognizes they are similar to other devices that are currently approved), but not FDA approved (which means the FDA has examined all the data in terms of safety and put their hand of benediction on them).  If Motiva does not get FDA approval, then they will no longer be sold in the US and your warranty will be worthless.Second, I don't understand the 265cc recommendation.  It doesn't make a lot of sense that to go a little larger will put you at significantly higher risk (such as rippling).  Either you are a candidate for over the muscle or you are not.  In other words, you need a certain amount of upper breast thickness to minimize your risk of visible rippling.Third, we have no idea what you look like or what you see as the end result.  265cc is not much of an augmentation.  My advice; consider seeking another PS who uses FDA approved implants by #Sientra,# Allergan, or #Mentor and be sure he or she has a lot of experience with breast augmentation (especially over the muscle if that is what you are considering).

Brooke R. Seckel, MD, FACS (retired) · Answer

My concern for you is that Motiva breast implants are not yet FDA approved. personally I recommended only implants that are FDA approved in this country,, Mentor, Allergan, and Sientra.Make certain that you are consulting a board certified  plastic surgeon who is experienced at cosmetic breast surgery.

Ronald V. DeMars, MD (Retired) · Answer

If you are "quite thin", the choice to go over the muscle is an odd one. Without an exam or at least good photos there is little else we can tell you. The Motiva is not an FDA approved device and so I have no personal familiarity with it.

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