Dr Daniel Medalie discusses breast augmentation and why he likes the IDEAL structured breast implant

  • Posted on: Apr 2 2019
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Walking Through Breast Augmentation With Dr. Medalie


When a patient comes in the door and she’s interested in a breast augmentation, she checks in, she goes into the exam room, and we put her in a nice, comfy bathrobe. When I come in we have a general discussion about the procedure. We address questions like:


  • What is the nature of the surgery?
  • How long does it take?
  • What’s the anesthesia like?
  • What’s the actual process?
  • What are the available options for implants?


Next, I take pictures of the patient from different angles. We take measurements and give her the specifics about what is a good idea in terms of augmentation for her. We go over sizing and the nature of the implants in terms of profile. And then, also importantly, we discuss the different types of implants.


A Candid Conversation About the Risks and Benefits of Your Options for Breast Implants


I think a lot of women come in with the idea that they want silicone gel implants, perhaps because they may have the reputation of being softer, or a little bit more natural in their appearance and feel. I show my patients each of their implant options. I’ll show them a silicone gel implant, a saline implant, and then I will show them the IDEAL IMPLANT® Structured Breast Implants. I just put each type of implant in their hand let them feel the differences for themselves. Then I go over the risks and benefits of each of these implants. This can be a five minute conversation if they’ve done a lot of research, or it could be a 15 or even 30 minute conversation.


Dr. Medalie’s Thoughts on IDEAL IMPLANT® Structured Breast Implants


Then the patient and I have the all-important discussion about which type of implant to choose. I’ve been using IDEAL IMPLANT for about nine months now. I discovered them at the Aesthetics Society meeting last year. At that meeting I thought about how all the FDA data has come back with the six year results and showed that the IDEAL IMPLANT actually has very good numbers compared to the other types of implants.


Proudly Introducing Patients to IDEAL IMPLANT


I decided I wanted to give my patients the opportunity to try the IDEAL IMPLANT. I kept a sample of one in my office and a number of patients would come in for breast augmentation and I would show it to them. We would discuss saline implants, silicone gel implants, and the IDEAL IMPLANT. My first patient who decided to try the IDEAL IMPLANT did it because It has good numbers, and because I told her I had no concerns about it. I gave her the options and I let her decide.


The patient had come in thinking she wanted saline implants because she was a little bit nervous about silicone gel implants. For this patient, there was no comparison when we put the saline implant next to the IDEAL IMPLANT. The IDEAL IMPLANT looked and felt much better than the saline implant. There was much less rippling and a much better feel. She said she wanted to try the IDEAL IMPLANT and so we did it. The surgery went fine and I saw her a little while ago. She had her six month follow-up appointment and she looks great and she’s happy.


IDEAL IMPLANT Puts Patients’ Minds at Ease


Some people come in and are on the fence about silicone gel implants. They’re a little bit nervous about it. They see the IDEAL IMPLANT and go, “Wow! I would definitely do this over saline implants.” They like the fact that it is filled with saline but its internal structure makes it look and feel better than a saline implant. It relieves these patients of that little nagging fear they had in their heads about silicone gel implants.


The LIfe-Expectancy of a Breast Implant


I tell my patients what every plastic surgeon should explain – there is a 100% chance of rupture of your implant at some point in your lifetime if you live to be 102. The patient may live for the next sixty, seventy, or eighty years with this implant, and it’s a manmade object. It’s probably not going to survive. At one point the implant is going to rupture. If it’s a saline-filled implant, you’ll wake up one Sunday morning and go, “Hey look, my left-side is deflated.” It can be a little bit embarrassing but the important thing is that you know right away and your body has safely reabsorbed the saline.


Silicone Gel Implant Vs. IDEAL IMPLANT: What Happens After a Rupture Occurs?


I’ve actually replaced saline implants under local anesthesia with some mild oral sedation in my clinic. I don’t take patients back to the OR for general anesthesia necessarily. Silicone gel implants are much harder to do. When silicone gel implants rupture, it may be a couple months before you notice it. The only way to truly tell whether a silicone gel implant has ruptured is to get a high-definition ultrasound or an MRI. By the time we detect the rupture there could be a change in your breast and I may have to go in and expand the capsule again. I may have to clean out the gel material. Most likely it would require a trip to the OR. It can’t be done in the clinic.


Any good plastic surgeon knows that a silicone gel implant is going to rupture at some point and sometimes it is a hassle to go back in and clean out the implant. Sometimes it is necessary to take out the entire capsule. It’s more involved than just going with the saline or structured implant. When my patients understand these risks, they start leaning away from silicone gel implants.


IDEAL IMPLANT Is Dr. Medalie’s Preferred Choice for Breast Implants


Just the other day a woman came in and said she’d seen on my website that I offered the IDEAL IMPLANT and that’s why she came to see me. I told her if I had to choose an implant, honestly, I would choose IDEAL IMPLANT. Even though I do a lot of silicone gel breast implants, personally, if it were for my family member, I would choose the IDEAL IMPLANT.


There was a recent meta-analysis study in which one of the co-authors at M.D. Anderson was looking at the problems with silicone gel implants. There was the possibility of a link between silicone gel implants and Sjogren Syndrome or a small auto-immune disease. It’s very unclear. The FDA vigorously disputes the link but it’s out there. It’s on the internet. People get nervous about that. Even I would get a little bit nervous about it and so I would go for the IDEAL IMPLANT.


Why IDEAL IMPLANT is the Best Option for Surgeons and Patients


To other plastic surgeons, I would say, “Offer IDEAL IMPLANT. What’s the worst that could happen?” Some surgeons are earlier adopters of new technology and others are not. I tend to be an early adopter because I like trying out new things. I will admit freely that with some new technology I realized there were problems. With the IDEAL IMPLANT I don’t have to worry about that because it’s been around for a number of years and it’s already had its first FDA approval. It’s not the next laser down the block that no one is really trying.


When you look at the IDEAL IMPLANT you can tell that it would be a good choice. If the data shows it has the low rupture rate and that people are satisfied with the operation, why wouldn’t you want to have that as an option for your patients? If a patient says, “I want the IDEAL IMPLANT,” you want to be able to offer it to them.


An Experienced Plastic Surgeon’s View on the Benefits of IDEAL IMPLANT


Some of the benefits of the IDEAL IMPLANT include:


  • It is filled with saline, which is, essentially, salt water. Your body will reabsorb it.
  • Early identification of rupture – If and when it ruptures you will know it very quickly because you will have a visible partial deflation.
  • There is no cause for concern for what happens with rupture as opposed to when a silicone gel implant ruptures, and it sits and it’s undetected for two months, six months, or even a year.
  • The IDEAL IMPLANT requires a smaller incision that silicone gel implants because it goes in empty, as opposed to pre-filled, like a silicone gel implant.


How IDEAL IMPLANT Compares to Saline and Silicone Gel Implants


In terms of looks, if you stand in the mirror, it will look the same no matter what type of implant you have. I have no doubt about that. Unless you’re extremely thin, it is hard to tell the difference just by looking at yourself in a mirror or looking at a picture, whether someone has a saline-filled or a silicone gel implant.


  • Saline Implants: The feel of a saline implant is what some people are concerned about. The biggest problem with saline implants is that patients are worried about the feel of rippling, especially on the side and below the breast. I think the IDEAL IMPLANT has solved that. It has very small micro-ripples that are almost unnoticeable and then when you put a little bit of tissue over that, essentially, you can’t feel the IDEAL IMPLANT.


  • Silicone Gel Implants: These implants are not perfect either because sometimes the silicone gel can fold and you can get a little crease in the shell of the silicone gel implant that actually feels like a hard point. There is no perfect implant in someone who is extremely thin. I would say that from a palpability standpoint, the IDEAL IMPLANT and silicone gel implants are the same. The advantages of IDEAL IMPLANT lie in the fact that it requires a smaller incision and you can detect early rupture and there’s no risk to the salt water filling. It’s just water.


The Ideal Solution for Cleveland Breast Implants


I’m a believer. I like the IDEAL IMPLANT because I think it solves some problems that heretofore were not solved. Saline-filled breast implants are less of a hassle down the road than silicone gel implants. The reason why people objected to saline implants originally was because they didn’t feel as good or look as good – especially on the side and underneath where the breast is thinner. Because it is a structured implant, the IDEAL IMPLANT has solved that problem. I like the name. I think it’s an ideal solution for what has always nagged good plastic surgeons.


Considering breast implants in Cleveland? Contact Dr. Daniel A. Medalie at Cleveland Plastic Surgery today to discuss your options. Simply call 216-393-9924 or visit www.clevelandplasticsurgery.com. Dr. Medalie’s office is located at 25700 Science Park Drive, Landmark Centre, Suite 190, Beachwood, OH 44122. Call today for more information on IDEAL IMPLANT ® Structured Breast Implants. *plastic surgery results may vary*





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