It has been a long time coming, but the new Allergan form-stable breast implant has finally arrived in the United States. The implant promises to provide surgeons with a new tool in their plastic surgery toolbox. The implant referred to by some as “the gummy bear implant” has a more cohesive gel filler than any previous implant offered on the American market. However the implant itself is not new and has been around for over 18 years in both Europe and Canada. After extensive testing in the United States the FDA has approved its use for cosmetic breast augmentation.
The patient who may benefit from this type of implant is one who desires a natural looking breast augmentation with a gentle slope to the upper pole the breast in a teardrop shape. These implants do not have the characteristic augmented look that many women have become accustomed to seeing in magazines over the past few years. The company tagline for the implants in an upcoming ad campaign is “keep them guessing”. So the question remains who is this implant right for?
According to Allergan Incorporated the company believes that the implant is well-suited for women who do not have a significant amount of breast ptosis (drooping) and desire that implant that more closely approximates the natural breast shape been previous round implants. The implants are slightly more dense and require a larger incision in which to place them within the breast pocket. Although the company states that the transaxillary (through the armpit) and periareolar ( around the nipple) incisions can be used, they advocate that most surgeons use an incision in the breast crease known as the inframammary fold. While this approach is used by over 87% of physicians, some patients still desire an incision elsewhere, and may avoid using the 410 implant because of this. One other thing to consider with the implant is that the cost is higher than traditional gel implants and for patients who are on a budget, this may not be the right choice for their surgery.
Time will tell whether or not the 410 implant catches on in the United States and it will be interesting to see if the implant’s natural shape causes a paradigm shift in the way people look at breast implant surgery. In my practice I have many patients that come looking for an augmented full upper breast, one that is not normally found in nature, and fully aware that they are going to have an implanted look. Many patients remark, “I want to look like I have breast implants”. For these patients, the 410 implant, will not be the right choice. I have no doubt that the American Society of Plastic Surgery will track this trend in the coming years. I have a feeling that the implant will have a certain niche within the market but will not become the standard for quite some time, if ever. Women have been working to make the upper part of the breast more full going back to Victorian ages when bustiers became all the rage. In the early 90s we had the Wonderbra, and today we have high profile and extra high profile implants that make breasts full and projected. I don’t think this trend is about to change.