I was very pleased to see the arrival of B-Lite implants recently on visiting one of our plastic surgery conferences.
The concept of manufacturing an implant that is lighter than the standard silicone implant is something that I heard about some time ago.
I talk about them in one of my Facebook Live Q&A’s here:
When I discussed this amongst a panel of experts I was in a few years ago, we were uniformly agreed that it would be beneficial if there could be a lightweight implant.
My patients often comment on the weight of implants and although I am always quick to point out that they feel heavier when you hold them in your hand compared to when they are in your body (because of the moment effect, see below). Nonetheless, they do still have a weight and obviously the bigger the implant the heavier they are.
B-Lite Implants – The Moment Effect
The moment effect is something that you might have heard about from your maths lessons and it is the concept that when a weight is held further away from a pivot point it creates a greater downward force than when it is closer to the pivot point.
This is why when you hold a box out with your arms stretched it feels heavier than if you hold it close to your body and so when breast implants are held in your hand or placed in your bra they feel heavier than when they are implanted in your chest and therefore closer to your body.
There is no doubt that breast implants alleviate a huge amount of suffering and unhappiness by restoring volume and shape to the breasts.
However, it is also true that carrying excess weight in your breasts can be uncomfortable which is why breast reduction surgery has such a high patient satisfaction rate.
The B-Lite implants are now available in the UK and you might think:
Great, we no longer use standard implants anymore.
However, you will find that we are very cautious about introducing new things, particularly in medicine.
This is particularly true in the field of breast implants with the recent PIP scandal although the PIP scandal was not created because a new implant was introduced to the market.
The PIP scandal was created because of criminal activity of an implant manufacturer in France.
Nevertheless, it has tainted the whole industry and made everyone even more cautious than they already were.
I am a believer in offering my patients all the available options which is why for some time now I have offered polyurethane foam implants where many of my colleagues do not even inform patients of their existence because they do not use them.
This is how I feel about the B-Lite implants.
They are new and I tell everyone that they are new and they are also more expensive than standard implants and so they may not be for everyone.
I also have to say that in my practice I do not tend to use very large implants as most of my patients are looking for a natural result in keeping with their frame.
I do not really see patients who have problems with the weight of their implants.
Having said that I am happy to talk about them although I do not necessarily recommend them because we do not have a large experience of their use and so we do not know what the results will be like in 5 or 10 years.
On talking to some of my colleagues, I know that they do not offer or mention these implants for this very reason because they want to see the long-term results.
This is perfectly understandable.
However, it does leave me to think whether we can be too paternalistic towards our patients sometimes.
As doctors go, I see myself as being on the conservative side.
I am not one to embrace new technologies or devices as any rep who has come to see me will tell you.
I certainly do not believe in trying to look for solutions to problems that do not exist.
In my breast reconstruction practice there are always new types of mesh or glue that are being introduced and claims that they will transform the operative time or the postoperative stay.
I have never been one to adopt them and would rather see the outcome through long term patient studies.
This is why I found it odd to be at the other end of the argument with the B-Lite implants and my colleagues were saying that they prefer to wait and see long term results.
I think the difference is that there is a significant element of patient choice when it comes to implant selection which is not true in breast reconstruction.
When it comes to selection of type of suture or mesh or whether glue is used or not with a reconstruction, I do not feel that the patient will have a significant opinion on this, so I feel I can make that decision on my own without involving the patient.
There are many patients who are happy to leave it up to the surgeon as to the type of implant too, but then there are also those who get very involved with the implant selection.
This is understandable because it is something that is going to go into their body for a very long time.
I do my best to facilitate the decision and present the pros and cons of each type of implant and I certainly have my own preferred makes and manufacturers but I am not tied to any particular make and so happy to discuss and offer any of the implants available as I have used most of them.
This is how I feel about B-Lite implants and I simply inform patients that they exist and give them as much evidence as I can so they can make an informed decision as to whether it is something that might be right for them or not.
It is not like they are a prototype or unlicensed, as they have all the relevant approval to be used in the UK. They are actually made in the Polytech factory which makes the polyurethane implants that we use.
I know that patients can be swayed by what we say and there is a lot of hyperbole used in breast augmentation surgery talking about the best method for this or the most advanced technique for that, but when it comes down to it, there is often no strong scientific evidence to support one method or technique over another and it is just an opinion, not facts.
Our job as doctors is to work through the opinion and look at the facts.
I also think our job is to pass those facts on to you to help you make a balanced and informed decision.
I will continue to mention B-Lite implants to my patients and give my opinion, but I will try not to sway you one way or another.