I am a breast surgeon. I did a breast fellowship; I am a female plastic surgeon in a private cosmetic surgery practice (so I see many women who want to enlarge their breasts); and breast augmentation remains one if not the most popular surgery for plastic surgeons.
So, now there is yet another choice for implants. How do you choose?
Many women think in order to get a natural look to the breast you need to put in a shaped implant. After doing this for over a decade, I would disagree with that statement. There are too many factors which affect “natural” look versus not: how much soft tissue do you have, what profile of implant, what volume, how does the surgeon place the implant, is the implant in front of or behind the muscle.
So if round implants are so great, what is the benefit of putting in the style 410? Why all the hoopla? There must be some reason.
- BENEFIT of 410:
- Lower capsular contracture rate. They quote 69% lower at 6 years. Now this may be muddied a bit- we know capsular contracture is multifactorial. Incision under the breast (IMF) has a lower rate than when done at the nipple/areola or in the armpit. The style 410 tends to be primarily put in through the inframammary incision, with a larger incision. The 410 was also limited in its use, so the surgeons on the study tended to be great breast surgeons with tons of practice- Maxwell, Teitelbaum and others. Does this affect the outcome? But clearly even with the muddiness, there is a real difference.
- Shape. Now for some patients I think this holds true. For the very thin coverage (read: no breast tissue, minimal muscle, minimal fat) I think the firmness of this form stable implant does help shape the breast. For those with more soft tissue or thicker muscle, the benefit may not be as great.
- They stay put. This is good for those with thin cover, where we worry about implant migration or bottoming out over time.
- NEGATIVES of 410:
- Cost. Gel implants are expensive. The style 410 is even more expensive.
- Larger incision. The recommended incision is 5 cm.
- Size. When using a shaped implant, you really need to stick with the measurements. I think breast measurements are good practice for getting a natural, pretty looking breast for any kind of augmentation, but with shaped implants you really can’t cheat. Too small or too large may not look good. So if you were heading for a high profile, higher volume implant, you are likely better served with round gels.
- They don’t move as much. Just as this is a positive (to help avoid migration or bottoming out) this can be a negative in that they don’t move as much. Some of the “naturalness” of the breast is from that movement.
- Not as much upper pole fullness i.e. cleavage. If you want fullness up top (and not even in a hoochie mama way, just in a full way) the style 410 won’t give as much there.
- Complications include issues with rotation, malposition, and double capsules or seromas. This may be offset though by less capsular contracture and migration.
- Difficult for those with stretchy skin or who are droopy
- ? Asymmetry harder to correct
So my thoughts?
I am glad to have it here. I think choices are great. For some women I think this will be a better implant than what we have had available, particularly for my non droopy incredibly thin and active Bay Area women. But is it right for YOU? There is no single answer I can print. This is why I personally meet with each patient for all their visits. I need to understand you- what you want to look like, what tradeoffs you would make- and see your tissue.
Welcome style 410 gummy bear!