Cosmetic Beauty Directory - Brazilian Implants

breasts

breast implant operations than any other doctor in

Australia and also has the most experience using

Silimed’s polyurethane foam-covered silicone-gel implants.

He explains why any woman considering breast implant

surgery should know about the option of the so-called

‘super-furry Brazilian’ implants.

Everyone considering breast implant surgery soon

discovers that the commonest complication is capsular

contracture. This is where the membrane, which grows

around all implants and which normally can’t be seen or

felt, behaves like shrink wrap, compressing the implant,

causing it to feel firm or hard and often distorting its shape.

Unfortunately this complication is by far the biggest

cause of dissatisfaction and the need for further surgery.

Evidence submitted to United States regulatory authority

the Food and Drug Administration by the two biggest

implant companies showed that by four years between 8

and 9 percent of primary breast augmentation patients had

developed capsular contracture. As some contractures

occur after four years it is inevitable these percentages will

increase as time goes on.

‘The contracture rate after all types

of breast surgery is dramatically

lower with polyurethane foam-

covered implants’

implants

In Australia there are now implants available which can

reduce this problem dramatically. Manufactured in Brazil

by Silimed, the implants have recently received approval

from Australia’s regulatory body, the Therapeutic Goods

Administration (TGA). This means Australian doctors can

now offer them to all their patients. Many years of use

overseas have shown that covering silicone gel implants

with a polyurethane foam surface reduces the risk of

capsular contracture to between 1 and 2 percent. The

foam covering feels like suede or fur – hence the name

‘super-furry Brazilians’.

This type of implant is not new. They were first used as

long ago as 1969. It is also worth noting that polyurethane

has been implanted safely in humans for decades for other

uses such as pacemakers and blood vessel grafts. Like all

silicone gel implants, the foam covered implants have been

improved over the years and now contain the same

cohesive gel as other implants.

Whenever a new implant is introduced it must be

rigorously assessed over a long period of time to ensure it

is safe. Since 1970 there have been more than 60 papers

published in peer-reviewed journals around the world

about the use of these implants. The papers have

confirmed their safety and the reduced rate of capsular

Dr Daniel Fleming from Brisbane explains

how these innovative Brazilian breast

implants, now available in Australia,

dramatically reduce the risk of capsular

contracture. Francis Herron reports.

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AUSTRALIAN COSMETIC SURGERY

D r Daniel Fleming from Brisbane performs more

breasts

contracture they effect. Here are three examples of the

conclusions of these papers:

Dr Neal Handel, an assistant clinical professor of plastic

surgery at the University of California Los Angeles,

reviewed all of the breast implant patients from his practice

in the period from 1981 to 2004 and found that 345

smooth implants, 618 textured and 568 polyurethane

foam-covered implants were used. He wrote this

conclusion:

‘Based on analysis of our data, we conclude that the

contracture rate after all types of breast surgery is

dramatically lower with polyurethane foam-covered

implants than with smooth or textured implants.

‘There is nothing to suggest that polyurethane foam, or

its in vivo breakdown products, pose a threat to the health

or safety of patients. Polyurethane implants have

measurable advantages over smooth and mechanically

textured gel-filled prostheses and do not appear to be

associated with an increased risk of complications or

morbidity.’ 1

Guillermo Vasquez, a plastic surgeon from

Buenos Aires, Argentina reported his experience

using these implants in 1,287 patients over an

18-year period. He concluded:

‘Currently, given our wide experience with

the use of polyurethane-coated silicone gel

implants, we may state they are the best option

for augmentation mammoplasty, and have the

lowest incidence of fibrous capsular contraction

(1 percent).’ 2

Dr Roderick Hester, Dr John Tebbetts and Dr

Patrick Maxwell from Georgia, Dallas and

Nashville respectively, reviewed the literature on

and their experience with polyurethane foam-

covered breast implants and concluded:

‘During the span of this author’s practice, he

has never been able to match the number and

quality of superior results exemplified by these

patients when using other devices.’ 3

‘The Brazilian implants are about $350 per

pair more than existing round implants, but the

teardrop-shaped Brazilians are still cheaper than

other similarly shaped products,’ Dr Fleming

says. ‘There is a slightly more limited range of

profiles with the Brazilians as only one company

has the technology to make them, so you have

to like their profiles. Lastly, these implants require

different techniques for insertion if they are to be

positioned correctly, so it is important that you

ensure your surgeon has plenty of experience in

their use.’

At the practice of Dr Fleming and his

colleague Dr David Topchian Brazilian implants

have been used for the last four years in

selected patients with individual TGA approval.

Their experience has confirmed the international findings

on these implants – very low rates of capsular contracture

combined with excellent softness and appearance.

Now that these implants have been approved for

unrestricted use by the TGA, the two doctors advise that

the Brazilian implants offer definite advantages for most

patients. ‘We recommend any patient considering breast

implant surgery should ask their doctor about these

implants and his or her experience using them so they can

make an informed choice,’ says Dr Fleming. acsm

1. Handel, N: ‘Long–term safety and efficacy of polyurethane

foam-covered breast implants’. Aesthetic Surgery Journal 26,

2006

2. Vazquez, G: ‘Polyurethane-Coated Silicone Gel Breast Implants

Used for 18 years.’ Aesthetic Plastic Surgery 37, 2007

3 Hester, T R; Tebbbets, J; Maxwell, G P: ‘The polyurethane-

covered mammary prosthesis: Facts and fiction II’. Clinics in

Plastic Surgery 28, 2001

Case study 1

Pointy or ‘tubular’ breasts like these are difficult and require particular

care with operative planning and technique to achieve a superior result.

BEFORE

AFTER breast implants by Dr Fleming

Case study 2

This patient’s natural breasts were very widely spaced and presented

real challenges to achieving a pleasing result.

BEFORE

AFTER breast implants by Dr Fleming

AUSTRALIAN COSMETIC SURGERY

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