Plastic surgeon Dr. Marc Mani thinks that many women will choose silicone implants over saline implants in the coming years. Make Me Heal sat down with Dr. Mani to ask a few questions that most women now considering silicone implants wonder about, namely, do they look and feel more natural than their saline counterparts and how safe they really are. This revealing interview is part of a series that Make Me Heal is conducting with well-known plastic surgeons who specialize in breast augmentation.
Make Me Heal: Have you started using silicone implants since the FDA approved their use?
Dr. Mani: I have been using silicone implants routinely for years, in reconstructive and secondary (revision) breast implant surgeries. I do a large number of revision surgeries (removal and replacement of implants, capsulectomies, and breast lifts with existing implants), and have been allowed to use silicone implants under a research study protocol in those cases.
I have started using silicone implants for primary (1st time) cosmetic augmentations since the FDA approved them for that.
My patients have been very happy with the silicone implants in both primary and secondary surgeries. I perform a lot of facial rejuvenation surgery, and often combine this with breast revision surgery to combine anesthetic and recovery time.
Make Me Heal: Do you think more women will opt for silicone implants than saline implants over the next 5 years? What percentage would you speculate will get silicone versus saline?
Dr. Mani: I think women will opt for silicone implants in the next five years more and more. Women who have been eligible for silicone implants in the last five years have been more likely to choose them over saline.
Make Me Heal: Do you feel silicone implants look aesthetically better and more natural relative to saline implants?
Dr. Mani: I feel that while saline implants can give an excellent result aesthetically, and in certain cases feel very natural also, silicone implants have an edge over saline because they have a compressibility that saline ones don’t have. Therefore they feel a bit more like real breast tissue. Also they are less likely to show “visible rippling” than saline, which grows more likely as the breast tissue thins out.
Make Me Heal: Do silicone implants feel more “real” to the touch compared to saline implants?
Dr. Mani: Yes, (see above), they have a feel that is more like breast tissue because of their compressibility.
Make Me Heal: Are silicone implants lighter, heavier, or have the same weight as their saline counterparts? The weight is very similar and not a factor in choosing one or the other.
Dr. Mani: Is the recovery from having silicone implants any different from having saline implants? Recovery is no different between silicone and saline implants.
Make Me Heal: Do you think silicone implants present any safety issue as far as rupturing and the potential health effects if silicone leaked to other parts of the body?
Dr. Mani: I, along with virtually all other plastic surgeons and researchers who have studied this issue, do not feel that there is a significant safety issue with rupture of silicone implants and leakage of silicone. The reports of health problems which culminated in the removal of silicone implants from the U.S. market in the 1990′s were extensively studied, and the data reviewed objectively over the years since, and the conclusion is that there is no association of silicone implants or silicone leakage with the health problems initially thought to be associated with them.
I tell my patients to review all the information they can about silicone implants, including a large amount of information that we give them, and make the decision on their own. Before FDA approval, I told them I felt the implants were safe but for them to make the decision on their own. Now I can tell them that the FDA feels they are safe too.
Make Me Heal: If you do not believe that there are any safety downsides to using silicone implants, are there any remaining advantages to getting saline implants now that the FDA approved silicone implants?
Dr. Mani: Saline implants can be inserted through the transumbilical approach, which I do perform to avoid scars on the breast. Silicone implants can’t be used for this procedure.
Make Me Heal: What is the ideal profile of a woman who should elect for silicone implants?
Dr. Mani: Today any woman who wants breast augmentation is a good candidate for silicone implants. The ideal candidate has small breasts, perhaps with a bit of excess skin from breastfeeding or “deflation” of breast tissue over time, and realistic goals and expectations for the procedure.
Make Me Heal: What is the profile of a woman who should not elect to have silicone implants?
Dr. Mani: I think someone who wants to avoid scars on the breasts as a very high priority, and therefore wants the transumbilical approach, is a good candidate for saline implants. The results with this procedure in my experience are excellent.
Make Me Heal: Finally, we wanted to ask you a few questions that patients who contemplate breast augmentation frequently ask that are not related to the silicone implants subject:
What is the best incision in your opinion?
Dr. Mani: I prefer the periareolar incision. It generally heals very well, as it lies at the border of pigmented areolar and normal skin. However, I offer all the available incisions (inframammary fold, axillary, and umbilical) and let the patient have a role in the decision.
Make Me Heal: Is it true that there is usually no loss of sense of touch of the nipples?
Dr. Mani: Yes it is true that usually there is no loss of sense of touch. There is a chance of alteration in sensitivity; some patients lose a bit, but it generally returns over time (a few weeks to a few months).
Make Me Heal: Do breasts with implants experience greater sagging over time than natural breasts?
Dr. Mani: I don’t think that, say, a C+ breast without an implant would sag more than a C+ breast with an implant over time. Large breasts droop a bit over time either way, and natural breast tissue droops as much as implants.
Make Me Heal: What bra do you suggest for post-surgery? Below is a link to some post-surgery bras (you can simply provide the url):
Dr. Mani: I use a compression wrap immediately after surgery which I put on myself. Then on postop day 2 I use a lightweight support bra like the Vianna or Yesmina bras. These are usually fine for the first six weeks; however, in some cases, I need to use something with more contouring ability in the inframammary fold, or a strap above the breasts to prevent implants from ‘riding up.’ The Allyssandra bras, or an underwire bra once the patient reaches the point where she can wear one, and the Georgette bra with strap are great for these two things respectively.
I have found that the first six weeks after breast augmentation surgery are a period where a lot of changes can occur with position of the implant and shape of the breast. Therefore I see patients back in the office regularly, and often use specialized bras as well as maneuvers like taping of the inframammary folds to influence these changes and improve the overall result dramatically.
There’s good news for those of you who want to ask Dr. Mani your own questions. You can write questions to Dr. Mani and get straight answers from the Doc in Dr. Mani’s area in the Make Me Heal Plastic Surgery Message Boards.
Dr. Marc Mani is a well-known Beverly Hills plastic surgeon and is certified by the American Board of Plastic Surgery. An artist from a very young age, Dr. Mani chose the field of plastic surgery for the ability it gives him to use his artistic eye in improving the lives of his patients. Aesthetic plastic surgery is the focus of Dr. Mani’s practice, including facelift; browlift; eyelid surgery; breast augmentation, lifting, and reduction; nose reshaping, body contouring surgery including liposuction, tummy-tucks, thigh lifts, and body lifts. Dr. Mani has been featured in the New York Times Television’s ten-episode documentary “Plastic Surgery Beverly Hills,” Dr. Phil’s, as multiple segments on “Extra: Hollywood Makeovers,” (NBC), Showtime Network, “Brand New You” (U.K., Channel 5 Network) and BBC features.
For more information, visit Dr. Marc Mani’s Website.
Tags: celebrity, plastic, surgery