Silicone Breast Implant Update

Since the wide release of silicone breast implants by the FDA in November of 2006, I have not used a single saline implant. In fact, my surgery center is sending our supply of saline implants back to the manufacturer to make room for silicone implants. On the rare occasion in which we need saline implants, we will have them shipped special order from the implant manufacturer.

For the past fifteen years, 90% of the breast implants used in the United States were saline. During that same time period, over 90% of the breast implants placed in much of the rest of the world were silicone. Most plastic surgeons anticipate that in time, over 90% of the implants used in the U.S. will be silicone.

When patients ask me, “Dr. Ryan, which implants are better, saline or silicone?”, I respond that, like everything else in life, they each have their pros and cons, so I can’t say that one is “better” than the other. I tell my patients that before 1992 (when he FDA put restrictions on the use of silicone implants), over 90% of implants placed were silicone and that I anticipate that we will return to close 90% usage in this country.

When patients ask me, “But aren’t silicone implants dangerous?”, I respond “Of course they’re dangerous! We doctors love doing dangerous things to our patients all the time! And the malpractice lawyers love it even more!” I then explain to the patient, after we both finish laughing, that there is no way that I — or any other doctor — would ever do a procedure or use a device that we feel is dangerous. I then recite the many well-done, peer-reviewed scientific studies that refute that there is any link between silicone breast implants and cancer, autoimmune disorders or any number of other diseases that people have tried to link with silicone breast implants over the years.

In summary, it appears that silicone breast implants are here to stay and that the vast majority of surgeons and patients are welcoming their return.

The Ribbon Lift

As I discussed in my April 4, 2006 post entitled "Jowls", the jowls can be a very stubborn problem. Since that last post, I have been doing a procedure called the Ribbon Lift. Unlike the so-called thread lifts, which many surgeons criticize as yielding disappointing results, the Ribbon Lift appears to be promising, since it is based on time-tested basic surgical principles. Furthermore, because the Ribbon Lift is based on sound surgical principles, the results seem to be long-lasting.

The Ribbon Lift involves placing a dissolvable device (the ribbon) under the skin of the face. An incision is made just below the sideburn and scissors are used to create a tunnel to the the jowls in the lower face. The ribbon, which measures about five inches long by less than a quarter inch wide, is a soft, flexible material with tiny points (like miniature spikes) at one end. It is made up of the same material that dissolvable stitches are made of. The ribbon is slid into the incision and the tiny points are pressed firmly into the jowl tissue. When the end of the ribbon is pulled up near the ear, the tiny spikes pull up on the jowl tissue as well. The jowls are thereby either eliminated -- or at least reduced significantly. A stitch holds the end of the ribbon in place and a series of stitches is used to close the sub-sideburn incision.

The procedure takes about a half hour and is performed with the patient wide awake, under local anesthesia. Some patients opt to take a Valium before the procedure, but this isn't necessary for most patients.

After the procedure, the patient is told to minimize activity for a few days. The ribbon dissolves after several months. For the first week or two, the ribbon can be felt if a finger is run along the cheek, although does not seem to bother the patients.

The Ribbon Lift appears to hold promise for the treatment of jowling and it has become a part of my armamentarium for the treatment of facial aging.

Please go to the "Videos" section of www.drfrankryan.com to a more thorough discussion of the Ribbon Lift.