The 3 questions everyone asks about Motiva breast implants [Lee B. Daniel, MD - Eugene, Oregon]

Dr. Lee B. Daniel (00:01):
The SmoothSilk surface of the implants is really the key, and if you look at the outside, the US studies, the incidence of capsular contracture is 0.43%. When you look at long-term, maybe even 10 year studies of current implants in the US, that capsular contracture rate can be 10, 12, 15% even. So that's the main reason for re-augmentation is capsular contracture. The two types of Motiva implants that use that SmoothSilk surface are what's called an Ergonomix and Round, so Ergonomix is more of the teardrop shape. We mentioned that earlier, but the way the silicone gel is made cohesive in the implant allows gravity to help mold that implant into more of a teardrop shape. It looks round when you look at it, but then when you have it vertically, it gives a little more projection in the lower pole of the breast and helps to develop the lower breast contours the best, which is typically where there is a deficiency for ladies that were thinking about breast augmentation. The SmoothSilk Round has a little more upper pole fill, so we talked about that as well with pre-pectoral implants, but not uncommonly people with significant weight loss. The moms who have maybe breastfed a few children, they have the mom situation, they have atrophy of the breast tissue above the nipple, and so an implant that is more of a round shape can preferentially fill in that spot a little bit better. Again, getting back to patient selection, I mean, yeah, that's all part of the evaluation and trying to figure out patients' wishes and where they want to go size wise, but it's almost perfect with the Motiva implants as to the different options that you have for really any patient that walks in for an evaluation. I'm really excited about this process.

(02:01):
What do they feel like if you're the patient poking yourself? Well, the interesting thing with the implants is that I think the density or the feel of the implants is very, very close to the native feel or density of breast tissue, and so it's almost like it's not there. After augmentation, other types of implants, the implant might move around in the pocket. You can kind of feel something shifting in there. It's a different way of really making the pocket for the Motiva implant. It's very similar to the old Replicon implants that I referenced earlier that I used in training. You wanted to make that pocket pretty tight so that implant didn't move around very much. But the cohesiveness or the cross-linking of the gel, for example, is such that it is really closely approximating native breast tissue density. I think many times we're never able to even tell that there's an implant in there in today's world, so always getting better.

(03:03):
Like I said earlier, there's two types. There's round and ergo, who would you put an ergo in versus a round and how's that woman going to be different? The ergo is going to, they both really can very easily mold the lower pole of the breast, and I think the insertion techniques are such that it is a little bit different, not that we have to handhold, whereas with some of the other implants that have been traditionally used in the us, kind of what you see in the operating room, oh, that looks great. Okay. That's what it's going to look like. Techniques that we use surgically for Motiva implants, it may not look exactly perfect on the table because we want this implant to do its work post-op as well, which is development of that lower pole. So there are some patients that have what's called a constricted lower pole that don't have much distance from the nipple to the crease under the breast, so that's going to be one that maybe needs the ergo version if they have enough of their own upper pole breast tissue, we really want that implant to fill that lower pole.

(04:08):
I think for the round that's more upper pole fill, although both still develop the lower pole nicely. Those are the things that as I make my preoperative measurements and talk with patients that we certainly absolutely 100% of the time spend a lot of time talking about. Motiva implants are available in your practice today. Absolutely. What do we do if we want to come in for a consultation? Consultations are always free. Coming in it doesn't cost anything. And again, for what we call the boob curious, I think patients that have been interested but just don't want to be too crazy big, the other word that I use is ballerina breast. People just want a small augmentation and traditionally people maybe wanted that C or C plus and now they come in wanting B's. So we could still do that with other technologies and smaller implants, but I think Motiva is really set for the future with regards to some of these maybe less is more augmentations, and so calling the office and talking to a patient care coordinator, we can get you in really quickly. The surgery's really quick as well. I mean, it takes an hour and 15 minutes maybe to do an augmentation. I think the one thing that sets us apart in our practice, I feel like I really do partner with patients through the entire surgical postoperative course. Everybody gets my personal cell phone number. They call me day or night regardless. You and I talked about earlier, there are no dumb questions, so I do this all day, every day and patients do this preferably once in their life, so I try to be there for them through thick and thin. Hopefully more thin than thick. Okay. Give us your Instagram handle and your website. drleebdaniel.com. We have a couple of other sites, but that'll direct you, and then Instagram handle is pretty easy to remember. @bestplasticsurgeon. That's you? That's me. I finally found him.