Adjustable Breast Implants

Expandable breast implants, also called inflatable adjustable implants, are basic saline implants that can be adjusted post augmentation operation. The concept of the implants comes from reconstructive breast surgery where an expandable implant is expanded on a weekly basis following surgery until the desired volume or size is achieved. That concept has migrated to cosmetic surgery procedures and leads directly to breast augmentation procedures as well.

Since the 1960s, implant choices have been silicone implants and saline implants. A saline implant is filled with as much saline as determined by the surgeon. A silicone implant is already filled by the company manufacturing the implant and is placed in the patient.

USE OF A PORT

The adjustable breast implant uses a port. The port is like a straw that goes inside the implant and is underneath the tissue and the subcutaneous plate. The surgeon pulls up the desired volume during the surgery and leaves a port buried in the soft tissue. Several months after the surgery, and depending on the size that the woman wants to achieve, the implants can actually go up or down as much as the patient wants within the confines of the implant itself.

DECIDING ON A SIZE

If a patient is undecided about the perfect size for their body, it is a good idea to choose an adjustable implant. The ability to adjust the size of the implants gives the patient time to determine the size that looks best on them as well as which size feels best.

Three months after the initial surgery after the swelling has resolved the doctor goes in and either puts more saline through the port or reduces the amount of saline in the implant. The expansion or deflation is performed using a small needle through the skin to reach the port. After the six month mark, the port is removed.  The decision of how big or small to expand the implants doesnot last a lifetime. It is really all about finding the perfect size for a given patient, achieving that size, and then removing the port.

ADJUSTMENT TIME

The adjustment is not one that the patient can do by themselves since it is done with a needle. However, it only takes around 5 minutes for the resizable breast implants to be expanded or lessened during an office visit to a doctor.  

IMPLANT PLACEMENT

The implants can be placed below or over the muscle or even the breast tissue as well. Around 90% of doctors place it below the muscle but there are some surgeons who like to go above the muscle. The implants can be placed either way and the placement does not affect the ability to adjust the implant.

ADVANTAGES

The main advantage of adjustable breast implants is the ability to have options available if a person is unsure about the size implants they desire.

MISCONCEPTIONS

One big misconception is that the implants can be increased or decreased at will by the patient. They cannot be increased for a Saturday night date and decreased by Monday morning for work. In theory it is possible but at the same time a patient does not want to risk an infection.

WEEKLY EXPANSIONS

Expanding and resizing an adjustable breast implant can be done weekly if the patient desires that frequency. As opposed patients using tissue expanders, when a breast is fully expanded, the breast that was removed is now a tight pocket. The pocket can be expanded and adjusted every week until it gets to where the patient wants it to be. Once the implant is where the patient wants it to be, it has to remain expanded to allow the tissue time to settle and stretch.

DISADVANTAGES

The main disadvantage of modular breast implants is that the patient needs to have a second minor procedure which is usually done under local anesthesia. The second minor procedure is to remove the port.

COMPLICATIONS

There are not very many complications with adjustable breast implants. There is not a great risk of infection. Patients are always given antibiotics during and after the procedure. If any kind of rupture occurs, the implant is simply removed and a new one is placed in the patient.

RECOVERY

The recovery time falls within a six month window. Three months after the operation, the adjustment period begins. There is a two month window (months four and five) during the six month recovery period where the implants can be adjusted. The port will be removed in month  six. From start to finish, it is six months from the surgery to the removal of the port.

It is important to note that if the patient is happy with the size the first or second time they are expanded, there is no reason to wait to remove the port.  The removal can happen anytime in the four to five month window.

It is also important to note that the final result where everything is settled takes about six months to a year.

HOW LONG DO THE IMPLANTS LAST?

Adaptable breast implants can last for a couple of decades although there is no guarantee they will last that long. Also, after ten years or so, there is a very small increase of incidents of rupture. The increase is as small as a couple of percent per year.

FINAL THOUGHTS

Adjustable breast implants are a good option for patients who are not certain what size they want to be. One of the best ways to describe the procedure is that it is like a permanent solution that offers you flexibility in the beginning. One of the first steps with any breast enhancement surgery is consulting with an experienced doctor. A skilled doctor can walk a patient through their options and help them decide which breast implant procedure is the best choice for them.

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Jeffrey Weinzweig, MD in Chicago, IL