Motiva Implants have recently come onto the market in Australia and they are taking Oz by storm! Today I had the pleasure of speaking about Breast Augmentation with Nano Surfaced Implants – a chat with Dr Andrew Broadhurst, Specialist Plastic Surgeon in Brisbane. Dr Broadhurst specialises in Breasts and Rhinoplasty. Here he shares with us what he loves the Motiva Nano Surfaced Implants.
Trish Hammond: Hey listeners, well I’m here today and I’ve got the pleasure of speaking to Dr. Andrew Broadhurst. Dr. Broadhurst is based in Brisbane at Newstead, and he is the director of enhanced plastic surgery. Welcome, Dr. Broadhurst.
Dr Broadhurst: Thank you very much, thank you for having me.
Trish Hammond: Yeah, thank you for taking the time out of your busy day, I know how busy you guys get. Today we’re going to just talk about breast augmentation with the new next-gen nano surfaced implants, which is the Motiva implants, which I know that you enjoy using. Before we go on about them, so tell us, what are your surgical specialties, and what’s the things that you love doing, what you’re great at?
Dr Broadhurst: All right, I hope I can answer that for you. My practise now is pretty much devoted to just breast surgery and rhinoplasty. Earlier in my career, I did a range of plastic surgery, I worked at the children’s hospital here in Brisbane for 10 years doing predominately cleft lip and palate surgery. Over time, I suppose my practise has evolved, and now it’s pretty much I suppose 50% breast surgery and 50% rhinoplasty. Breast surgery, that really includes breast augmentation, breast augmentation with breast reduction. I don’t really do any reconstructive breast surgery.
Trish Hammond: Okay, so pretty much you just do the aesthetic breast surgeries, the implants, the lifts and reductions.
Dr Broadhurst: That is correct.
Trish Hammond: And rhinos.
Dr Broadhurst: And rhinoplasty, I really enjoy rhinoplasty, and they’re really quite different types of surgery, which is why I enjoy doing both of them. I suppose rhinoplasty, a lot more attention to very fine detail, and I suppose it’s a longer operation and a bit more technical perhaps than breast surgery, but yeah, I like doing both.
Trish Hammond: Yeah, that’s good, gives that bit of variety.
Dr Broadhurst: Exactly, exactly.
Trish Hammond: Awesome. I know that when people have breast augmentation, there’s all this stuff in the media lately as well, you know likely complications and all that sort of thing. What I was going to ask you is, what are the main like the complications with anyone having a breast augment, and how can these complications be risk controlled or minimised?
Dr Broadhurst: That’s a very good question, and difficult to answer in a very short period of time, but I can do I suppose a quick overview. I suppose anytime you have a surgical procedure and you have an anaesthetic of some form, there can be complications related to the anaesthetic, and you know for the sake of today, I think we can just leave those out of it, because they’re the same for any operation that you might have. Specifically as far as, let’s limit ourselves to breast implants, as breast surgery goes, technically we divide these up into complications that can happen early on in the piece, and then those that can happen later down the track.
In terms of the early complications, I suppose the one that bothers us the most, but is really pretty uncommon, is hematoma. Hematoma is just a collection of blood around the implant, usually presents with a lot of swelling around the implant and discomfort, typically in the first 24 to 48 hours after surgery. In the majority of cases, that needs a second operation to evacuate the blood, usually it’d stop bleeding by that stage, evacuate the blood, the implant can stay in. It’s really just an inconvenience, as opposed to having any significant impact on the outcome of the procedure.
Further down the track, you can get something called a seroma, which is just, again, a collection of fluid, but not blood, around the implant, which can be a little bit problematic. Further down the track, something called capsular contracture, which really is associated with any implantable device, and the risks of it I think vary a little bit depending on which device you’re using, what technique you use to insert the device, but as yet, we have not come across a device that is immune to capsular contracture. Capsular contracture really just presents as firmness of the breast. As it becomes more advanced, the actual shape of the breast can become distorted, and then finally it can actually become quite painful.
Trish Hammond: Yeah, right. I’ve seen all of those, some situations come through on our groups, and it’s not fun when something goes wrong, that’s for sure.
Dr Broadhurst: No, I suppose in terms of completeness, there are other more, I suppose, risks. Are there more complications? Absolutely there are, but those are by far the most common ones we see. The other one that I suppose is topical at the moment is something called anaplastic large-cell lymphoma, and that is a very rare condition. Everybody’s heard about it in the plastic surgery world, but the majority of us actually have never seen anyone with anaplastic large-cell lymphoma, and I’m in that category. We’re suspicious and we obviously investigate people for that, but I’ve never actually seen a case myself, but again, it presents with a swelling of volume of fluid around the implant.
When tested, that fluid contains what we call lymphoma cells, which is the type of bloodborne cancer, if you like, but in the vast majority of cases it’s contained within the fluid around the implant, and the treatment is to remove the implant, remove the fluid, and the capsule that the body has made around the implant, and that’s curative in the vast majority of people.
Trish Hammond: Well, on that ALCL and lymphoma type of risk, what could be done to help to minimise or reduce the risks, like by you as a doctor, and I don’t know about by the patient, but like can we have a better starting point?
Dr Broadhurst: I think the answer to that is yes. As with all things in medicine, you know our knowledge increases over time, and this has I suppose only been reasonably recently, as in the last couple of years, recognised as an entity. Our knowledge about it, it’s good, but it’s not as complete as it will be with more research. As far as we know, the condition has never been reported in people who only have used smooth-shelled or smooth-surfaced implants. I suppose we divide the implant surfaces up into what we call textured surfaces, and there’s a whole range of different types of implants and different types of texturing.
Then there are implants that we say have a smooth surface, and they’re essentially a very similar surface. To date, nobody who has only had the smooth surface implant has ever developed this condition, which leads us to believe that it’s related to the texturing of the implant. There are lots of different types of textured implants, and again as far as we know, and I’m saying “as far as we know” because we don’t have a complete set of data on this, but it appears that perhaps there are different types of implants that have different risks, some are a bit higher and some a bit lower, but we know that the smooth shell implant at the moment, current information tells us that there is no risk of ALCL.
Trish Hammond: That’s really reassuring. On that, so why should women … They should really, and I just want you to kind of explain why, but women should really do their homework on the type of the clinic or the surgeon that they choose to have their surgery with of course, so why is that?
Dr Broadhurst: I think lots of people don’t I suppose give enough thought to cosmetic surgery before proceeding with a procedure. I suppose if you’re, by way of analogy, if you’re going to go and change your hair colour, you can wake up one morning and decide that you want to be blonde when you used to have dark hair, you can change your hair colour, and if you don’t like it, it’s very easy to change it back, and you really haven’t lost a lot. Cosmetic surgery is not like that in any way, shape or form, and I think it’s very important that people who are having or considering cosmetic surgery, do a lot of research.
A lot of that research really involves just thinking about what you’re going to do in terms of, if we’re talking breast implants, for example, what size do you want to be, what activities do I like doing that whereby larger breasts might impact on my ability to perform that activity or enjoy doing that activity? I think that’s one of the keys, is definitely think about how it’s going to actually impact your life, make sure it is really something that you want to do, not something that perhaps your partner suggests that you should have done, that it’s something that you really want to do yourself.
Don’t rush out and get breast augmentation because you thought about it yesterday, you know think about it for weeks or months, until you’re 100% sure that is what you want to do. Most importantly, if you have reached the decision that you want to proceed and actually have an operation, then I think you really need then to do some more research and find a reputable plastic surgeon, and there are plenty of those around. More importantly, you need to probably get more than one opinion.
It’s always difficult, because when you get more than one opinion, those opinions might differ, and that can be a source of confusion in itself, but I would get multiple opinions. Then in terms of actually choosing a surgeon, choose a surgeon that listens to you, rather than someone who tries to sell you something that’s perhaps not exactly what you want, and most important, that’s honest with you, that tells you that’s an achievable goal, or that’s not an achievable goal.
Trish Hammond: Yeah, and you’ve got to really have that connection with them as well, haven’t you, you’ve kind of got to like … Yeah, and people will know anyway, be like, “Yep, that’s the person that I need to see, because …”
Dr Broadhurst: Yeah, I mean I think you need to be able to establish some rapport with the surgeon who’s going to do your operation, and that’s a little bit difficult being that you might only meet them for a half an hour or an hour on your first meeting, but I think if that’s someone that you like that you think understands you, then that’s a good starting point. I suppose talking from the other side of the desk, as a surgeon, you know probably the majority of patients that come into the office you get on well with and you like, and they’re the people that you do want to operate on. You know every now and then, someone comes in that maybe they just, you don’t have a good personality match, and that you would prefer maybe not to operate on.
I think as a surgeon, you need to communicate that with the patient, just go, “Look, I don’t think I’m the person to do your operation.” As a patient, you might look at the surgeon or talk to them and say, “Look, they say everything and they’ve told me everything, it all sounds fine and adequate, but I don’t really gel with this person,” then don’t have an operation.
Trish Hammond: Same thing. Yeah, totally.
Dr Broadhurst: Go see someone else.
Trish Hammond: Totally, totally. I know like not many women generally know what sort of implant they’d choose, and I know that you use the Motiva breast implants for your breast augment patients. I was going to ask you, what’s one of or what are the features that you like about the Motiva breast implant range, and why?
Dr Broadhurst: Motiva breast implants are relatively new in Australia, they’ve been available for not quite two years now. Motiva have, rather than copied everybody else’s technology, have developed their own technology in terms of manufacturer of breast implants. I suppose we were talking previously about anaplastic large-cell lymphoma, and they have designed an implant that technically has a nano-textured surface, but in terms of how it’s classified, it’s classified as a smooth shell implant. What that means is the risk, as far as we know, of getting anaplastic large-cell lymphoma with a Motiva implant is zero, so that’s a huge benefit, and it means it’s something that really you don’t have to think about anymore.
Other benefits of the Motiva range are basically it can come down to the way the implant is manufactured, and the shell and the gel within the implant are basically all one. Conventional implants have a shell and a filling, whereas this implant is basically all one. As soon as you feel it, it feels completely different to every implant. I see patients in my office and I give them a Motiva implant, and I give them a couple of other brand implants, and the vast majority of people would choose a Motiva implant based on the way it feels. We do another exercise where we stretch the implant, just to demonstrate how robust it is, and you would be surprised how much you can deform and twist and turn the implant, and it returns to its original condition.
We do that 10 or 15 times a day, and have had the same implants, and we’ve been doing that for close to two years, and all those implants still look like the day they arrived, so very robust implant. I suppose other technical issues with it, is they have a very vast array of sizes and shapes and projections of implant, and they essentially have two types in terms of one that they classify as a round implant, and the other implant, which is what they call their ergonomics brand, which they effectively market as an anatomical implant. It technically isn’t, it is a round implant, but it behaves once it’s placed in the body as an anatomical implant. Very broad range, excellent construction, all based on design and research, and I think they’re the best implants on the market.
Trish Hammond: That’s awesome.
Dr Broadhurst: For the vast majority of people.
Trish Hammond: Yeah, I mean I don’t know much about implants because I’m not really an implant person, but I remember when they first came out and I was like, “Wow, these are going to be a bit of a game-changer.” You know, I think I was introduced to them either one or two years ago, and I was like, “Wow, this is just what,” being Australian, I reckon, you know new, next generation implants.
Dr Broadhurst: Yeah, I mean it’s funny, you know implants really do go, this is the third, and this is the fourth, and this is the fifth generation implant. In essence, there were some subtle differences in all those implants over probably the last 20 years, but this is the first implant that’s come along which is out of the box just, it’s completely different. It has a different construction technique, it is a different construction, and is completely different to all the other ones.
Trish Hammond: I imagine that Motiva are really dedicated to continuous improvement, so they’re still researching and developing as we go, which is really good because I think the good old implants have been around forever, haven’t they?
Dr Broadhurst: They have, and I think people probably 10 years ago went, “Look, there’s not much more we can do with implant technology, what we have is what we have.” Thankfully, there were some people who thought otherwise. I haven’t been to their research facility, but I’ve seen some footage of it, and it’s quite an impressive facility in Costa Rica, and they’re researching in all spheres of plastic surgery, particularly breast implants, and they have quite a few new products on the horizon that I think will make cosmetic breast surgery safer and better in the future.
Trish Hammond: That’s awesome, that’s so good to hear and so reassuring for the ladies out there, or men I guess, that are looking to have breast implants. I was going to ask you, so Motiva’s Silk nano surface is said to help reduce complications with breast implant surgery. How does that work?
Dr Broadhurst: That’s an excellent question, and one that we understand reasonably well, but probably not completely. I mentioned before that the texturing on implants varies, and even though Motiva implants are technically classified as smooth shell implants, they are not. If you look at them under a microscope, they have what’s called a nano texturing, and that’s quite different to the texturing on what we would consider a textured implant, which is clearly visible with the naked eye. It’s the nano texturing and the shell wall composition which reduces the risk basically to zero of anaplastic large-cell lymphoma.
It also reduces risk of seroma, there’s less tissue reaction. People, again, have been trying to develop an implant, both filler and the shell of an implant which minimises tissue reaction, and this nanotechnology seems to have achieved that. Less tissue reaction, and that means that the risk of seroma around implant is much less, the risk of capsular contracture is most likely to be significantly less. There’s supposed to be rotation in the short term to the tissues, and I personally think that probably leads to a faster recovery, and even possibly less postoperative pain.
Trish Hammond: Okay, okay. I was going to also ask you, with the Motiva ergonomics implant, that’s the same?
Dr Broadhurst: Yes. The two Motiva implants available in Australia, both have the same shell, so they both have the same nano textured shell, and it’s really the shell that interacts with the body, and that interaction is minimised as best we can with the nano texturing, so it elicits the least tissue inflammatory response. We presume that’s why the risk of seroma is less, the risk of capsular contracture is less, and probably post-operative pain is less as well.
Trish Hammond: It’s like anything, I mean because I know that they’re a little bit more expensive, but the thing is in five years’ time, that little bit of extra is not going to make any difference. If you’re going to put implants in your body, why wouldn’t you put the best that are on the market, really?
Dr Broadhurst: Yes, I mean I suppose you’re right, that’s a different philosophy on that one, but I think when it’s your health that’s at risk, you need to do everything to maximise the chance that you’re going to be happy and minimise the risks. There are obviously costs associated with breast augmentation, and the cost of the implant is just one of those, but really the difference between the average, for example, textured teardrop-shaped implant and a Motiva implant is not that great, it really isn’t. It’s a very small difference, and you know if it’s your well being or your safety that’s at risk, then to me it’s crazy not to-
Trish Hammond: I agree, totally.
Dr Broadhurst: Choose the best product, and minimise your risk.
Trish Hammond: Totally, totally. I wanted to ask you, just I’ve only like a couple more little quick questions for you, because I know you’re really busy, but Motiva likes to be known that they’re the implant for the active woman, so how soon can patients start to exercise once they have Motiva implants?
Dr Broadhurst: I think everyone approaches that slightly differently, depends a little bit on what position we put the implant, whether it’s under the muscle or on top of the muscle. I think in terms of when we do this operation, we spend quite a bit of time and effort placing the implant in the exact position that we would like it, and we would like it to stay in that position. To do that, basically you need to rest. I tell all my patients that for the first two weeks, we don’t want you doing any what we would call “physical exercise”. You can be moderately active, you can still have a shower, you can get dressed, you can do your hair, you can pick up your children, all those sorts of activities, but in terms of going back to the gym or activating your pec muscles, jumping up and down, those are things that could potentially displace the implant, and we’d prefer that you didn’t do those.
I tell all my patients that for the first two weeks, gentle exercise in terms of you can go for a walk, you can ride a stationary bike, activity where you’re not jumping up and down, an activity where you’re not using your pec muscles is fine in the first two weeks. After two weeks, then you can slowly increase your level of activity, and after six weeks, there’s no restriction on your ability to do any exercise.
Trish Hammond: Okay, so it doesn’t really take that long. I mean, that’s not a long time to wait, really.
Dr Broadhurst: It’s funny, because for the vast majority of people, again, it’s not that long. There are people out there who are addicted to going to the gym, and for those people, when you say “six weeks”, that sounds like a very long period of time. But the reality is, once you’ve had the operation and you’re a bit uncomfortable, you know two weeks has passed before you’re even really considering doing too much in the way of exercise. Then you’ve only really got another four weeks to go, and you’re back into it.
Trish Hammond: The thing is, you have to listen to that advice, because I have heard and seen situations of women who’ve gone out and done exercise shortly after, lifted weights or whatever, and then it’s just going to stuff up the job that you’ve just had done, so you really need to listen to that advice, don’t you?
Dr Broadhurst: Yeah, I mean very important, again, I suppose similar in a sense to choosing the best implant, you’ve made a significant investment on getting breasts that look better and are bigger, and it makes complete sense to follow the instructions. Okay, six weeks might seem like a long time, but at the end of six weeks, if all has gone well, your breasts will look great, and you can go back to the gym, you can do whatever you want, and it was really only six weeks out of your exercise life, and that’s time well-spent.
Trish Hammond: Totally. I’m going to ask you this question here, but this is like, I don’t know. Why would you say that any woman thinking about having breast surgery should come and talk to you?
Dr Broadhurst: Excellent question. I think, and I alluded to this before, and that is I think to get a really good result from breast augmentation, you need to meet a couple criteria. You need to know what it is that you don’t like about your breasts, you need to know what you want your breasts to look like, and I think some women know what that is and some don’t. I do spend quite a bit of time reviewing photos of people who have had breast augmentation surgery with prospective patients, and that helps them gain the best possible, I suppose, feeling of what they want their implants to look like in terms of their breast shape, and also breast volume or breast implant size.
I think that’s really really really important, and then you need someone who is going to talk to you, most importantly, listen to you, work with you, and who hopefully has the same expectations that you do. I think, and I tell all my patients this, I said, “Look, if at the end of this whole consultation process, your expectation is the same as my expectation, then you’re going to be a happy patient. If for some reason are expectations are not aligned, then there’s a potential for trouble. If we identify that as a possibility, then we go back to the drawing board and we start the process again.”
I think you need to choose a surgeon who can do that with you, and work with you as long as it takes. Sometimes it takes two consultations, sometimes it takes five, but again, all that is time well-spent, you don’t get that time again once you’ve had your operation, and you definitely don’t want to have an operation and then think back, “Oh, I wish I had done this, I wish I had gone smaller, I wish I had gone bigger, I wish I had a different surgeon.”
Trish Hammond: Yes.
Dr Broadhurst: All those details out beforehand, and that takes time. I tell all my patients, “Look, I want you to come back as many times as you need to, until you’re happy and are 100% committed to surgery, then don’t book an operation ’til you’re 100% committed.”
Trish Hammond: Yeah, and that’s so true because you want to go, I don’t know if this is probably a little bit esoteric, but when you’re going under, you want to go under 100% confident in your choice of surgeon, your choice of procedure, your choice of process. You just want to close your eyes knowing that everything is exactly as you want it to be.
Dr Broadhurst: Absolutely. I think if you’re 100% committed to an operation, then that’s almost a prerequisite, but it also means that, we know this, you’re much likelier to be happier with the outcome. If there are any little hiccups or bumps along the way in terms of you did get a hematoma or something wasn’t quite perfect, you tolerate all those so much better because you were highly motivated and committed to surgery. Whereas if you’re going, “Oh, my friend’s getting it, so and I was always thinking about it, I might just get mine done when she does,” then you’re not 100% committed. You might not really know what you want, you haven’t given it enough thought, and you definitely don’t tolerate the process in terms of discomfort in recovery, you just don’t recover as well and you don’t tolerate any potential complications that might arise anywhere near as well.
Trish Hammond: I’m going to finish off today, and thank you so much for your time, but I want, like if there was one piece of advice that you could give women who are going to go and have surgery, whether it be breast implant … Or actually, even just breast implant, like what’s one takeaway piece of advice that you would like people to know?
Dr Broadhurst: It’d probably be about size of implant. Lots of people come in and they want the biggest implant that they can get, or they want a significant increase in size. I tell everyone implants will do two things for you: They will definitely make you bigger, that’s clear to most people, but they’ll also improve your breast shape. As the size of the implant goes up, your breast shape gets better and better to a point, and after which the shape of your breast probably deteriorates, it just becomes rounder and less breast-like. Unfortunately, also the risks and the complications go up at about that same point.
I tell people when people say, “Look, what size implant shall I choose?”, I just go, “Look, choose the smallest implant that’s going to make you happy, because implants, they do have risks, they do have complications, and we know for a fact that all those risks are lower the smaller the implant. In addition, your breast shape will be better if you don’t go too big. I accept that lots of people want to be big, and that’s their primary motivation, but I suppose my advice is don’t lose sight of shape, shape of breast is really really important.
Trish Hammond: Awesome. Can I sneak one more question in? Say for example, you’re saying about you use the smallest implant that you can, it’s to make you happy. If someone in their 50s or 60s or whatever just say, “Okay, well I don’t want to have to replace my implants every so often,” could they have those implants in and just think, “Oh, well that’s it, that would last me the rest of my life,” or not necessarily? I mean, I suppose that’s a really broad question, but is it possible?
Dr Broadhurst: That’s an excellent question, because I suppose that kind of leads into, “How long do breast implants last?” That, again, difficult question to answer quickly, but Motiva implants, for example, company provides them with a lifetime guarantee. Now, what does that really mean? To me, that means that the company has a lot of faith in their implant. Does anything last forever? I think probably it doesn’t, but it means they’re probably going to last for 20, 30, 40 years. I think if you choose an implant that’s not too big for your body, that’s not going to have deleterious effects on your breast tissue, then it wouldn’t be unreasonable to expect that maybe in 20 or 30 years, the implant will be fine, your breast shape will be fine, and you’ll be happy with the result.
Trish Hammond: Wow, that’s amazing, I had no idea that they actually came with a guarantee, so I’m really glad you answered that question. Well, that’s awesome. Thank you so much for your time today.
Dr Broadhurst: Awesome.
Trish Hammond: That’s been a real eye-opener, there was stuff in there that I had no idea about, and it’s great to share that information with ladies that are looking at having breast implant surgery. Thank you so much for your time today.
Dr Broadhurst: My pleasure.
Trish Hammond: Awesome.
Dr Broadhurst: Thank you.
Trish Hammond: No worries. Ladies, so if you’re looking for a plastic surgeon in the Brisbane area, or actually anywhere around Australia, because people will travel these days, and you’d like to go and see Dr. Andrew Broadhurst, as I said, he’s in Newstead in Queensland. You can just Google him at “enhanced plastic surgery”, or you can drop us an email to email@example.com. Thanks very much, Dr. Broadhurst.
Dr Broadhurst: Pleasure talking to you.
Trish Hammond: No worries. You too, bye.
Dr Broadhurst: Thank you, bye.