What do Motiva breast implants feel like? [Dan Zegzula, MD, Portland]

Eva Sheie (00:00):
You're listening to Where Before Meets After. Would you say it feels like a breast?

Dr. Zegzula (00:05):
It does feel like a breast. When the implants are in, they feel very much like a breast. It's hard to tell that they're there, and I think that's the best outcome. When you can't really feel the implant, it's there, but you can't really feel it.

Eva Sheie (00:17):
I would say 20 years ago, someone I knew who had worked in the breast implant business for a really long time said, here's how I was sort of asking, how do you know if you'll like having breast implants? And she said, you have to be used to the idea of feeling something inside your body all the time. It's like it's always there. You get used to it always being there, but you definitely know that they're there. And I wonder if these might have a little less of that presence.

Dr. Zegzula (00:48):
I think they will for a couple different reasons. One, the subtle feel of the implant, but two, the fact that the body isn't going to be responding to it in the same way, the feeling of having a foreign body in the feeling of having a breast implant. Many patients do have that, and it tends to always be there. The patients that don't have that, I call them the lucky ones, where they have absolutely no sense that they have an implant any longer. Their body has completely accepted it as its own. They can't even tell it's there. They say they know it's there, but that can't tell it's there. And some people get there sooner than later. Sometimes when I see my patients at their three month and they tell me they really can't feel their implants, they're going to be good for a long time. They're not going to have problems with capsular contracture or pain. And sometimes it takes a little while, sometimes it takes six months, sometimes it takes a year. When I follow my patients up, they'll say, yeah, it took several months, but I finally got to a place where I don't feel my implants anymore. And others they do. They kind of always know that it's there. It's not necessarily uncomfortable, but they say, oh yeah, I can tell they're there.

Eva Sheie (01:54):
Do you think that feeling is maybe more prominent in people who are athletes that run or jump or do lots of really busy things with their bodies?

Dr. Zegzula (02:05):
I think one of the reasons why people feel their implants is when they're under the muscle. I think the stretch of the muscle over the implant is one of those feelings that a lot of people have a hard time getting used to. Especially with larger implants, the muscle is stretched to a pretty significant degree and your muscles can feel that. It's like when you're in one position for a long time and you just feel like you need to stretch your back because you've been sitting at a desk for a long time. I think there's some feeling in the muscle that when the implant is there, you can't get past it. And again, some people accept that very well and others don't. They always have a sense of tightness or a bra that they can't take off. One of the beautiful things about going above the muscle is that that sensation doesn't happen.

(02:51):
The muscle is in its natural state. When you exercise that muscle, when you use that muscle, it's not changing the shape of the implant. And patients don't have a sense of tightness in their chest or tension in the pec that they might have when the implant's under the muscle. If we circle back to Motiva implants, Motiva implants, their favorite position is in a subfascial position or above muscle placement because the implants tolerate that well, there's very little reaction around the implant. So capsular contracture rates are low, which was one of the reasons people felt like they had to put implants under the muscle was to reduce capsular contracture. And then they have a very natural feel without having tension in the muscle. And also the breast looks quite natural when you augment the breast with an implant directly behind the breast. You're actually truly augmenting the breast itself, not augmenting the breast and the muscle at the same time, which is always going to have some unnatural shape and feel to it because you're pushing the muscle forward and the muscle is not part of the breast. The muscle is a separate structure.

Eva Sheie (03:54):
Very logical. So I think you're saying your preferred approach is over the muscle. Do you ever do under the muscle for any reason?

Dr. Zegzula (04:01):
Yeah, some patients just really want it. Their friends had it that way. They just want to have it just like their friends. But I try to approach each patient separately and look at their anatomy. If they truly are very lean, very low body fat content, very little breast tissue, they will be at more risk for visibility of their implant unless we put it under the muscle. So I think there is definitely a place for submuscular breast augmentation, but it's an independent decision for every patient. We have to discuss the risks of the animation of the breast when it's under the muscle, and the potential for discomfort with activity versus the potential of visibility of the implant. And you'd be surprised that the vast majority of patients have enough breast tissue to hide their implant pretty well. But those that don't, we still use under the muscle positioning, and usually that works really well and they're very happy. There's definite pros and cons, but there's a solution for everybody I think.

Eva Sheie (05:00):
Thanks for listening. I'm your host, Eva Sheie. Follow the show and submit questions for our experts at wherebeforemeetsafter.com. Where Before Meets After is a production of The Axis.