Dr Niamh Corduff, specialist plastic surgeon, talks Motiva implants – but this podcast is much more than that. Dr Corduff discuss just about everything you want to know about having breast implants after having babies, including breast implant complications such as capsular contracture, how long after your breast augmentation you can start exercising and so much more. This is one for any woman looking to have a breast augmentation or breast implants.
Trish: Good evening, podcasters. I’m here tonight with Dr. Niamh Corduff. She’s a specialist plastic surgeon who practises from the Cosmetic Refinement Clinic in Geelong in Victoria. Today we’re going to have a talk about the Motiva implants and active living and breast implants after babies, so thank you so much for joining us, Dr. Corduff.
Dr. Corduff: You’re welcome. Nice to talk to you, too.
Trish: Yes, thanks for taking the time. We’ve got a few questions that we’re just going to ask you. I know you’re a real advocate for the Motiva implants, but we’re going to talk more about after babies today, so what’s the most common breast concerns that mothers can be faced with today?
Dr. Corduff: Two issues most commonly. One is that their breasts have deflated after breastfeeding, and secondly, that the breasts have dropped after breastfeeding. Both of those issues, women feel like they’ve lost their femininity a little bit and may seek surgical help to address that.
Trish: Okay. What surgical options do they have?
Dr. Corduff: Well, the options are to reshape the breast using surgical techniques, and that may need an implant with it or may not, or sometimes if the breast hasn’t dropped, it’s just deflated, then you can use just the implant to restore volume.
Trish: Okay. After breast implants, what are the main complications that can be associated with them, and how can and does Motiva help with this?
Dr. Corduff: Well, probably the commonest problem that we have had is the decision making and the agreement between the patient and the surgeon and what’s compatible with the patient’s body, like selecting the size, the shape, the volume, and making sure that you get that right for the patient. That’s probably one of the hardest things is trying to understand for the patient, often by the time they get to see the surgeon, have really quite fixed ideas of what they would like to be. The hardest thing as a surgeon is to look at the patient and go, “You can’t have that,” and then you have to compromise and say what you can and what you can’t without getting into trouble and getting complications, because to be perfectly honest, the body has limitations and the implants will fit you like a pair of pants will fit your body, a shirt will fit your body. It’s the same thing with breast implants. They have to fit your body and be the right size, and when you step outside those limits and push those boundaries, that’s when we start to see the complications really get more and more. That is one issue.
The other issue is the long-term issues when surgical complications, such as capsular contracture is probably one of the hardest, most common problems that we’ve faced over the years, which is scar tissue around the implant, which over time can start to squeeze and constrict the implants and become firmer and harder and rounder and just looks weird. Those are really probably the commonest. Of course, there’s also ruptures and there’s various other issues as infections and so forth, but capsular contracture and rupture is probably the commonest things we see.
Trish: Yes, yes. On the capsular contracture, what is it and how does the Motiva silk nano surface help to reduce this?
Dr. Corduff: Well, it’s a very complicated issue, but when you put anything foreign into your body that’s not meant to be there, your body looks at it and goes, “Don’t like this. Let’s wrap it up, seal it off, and wrap it up in scar tissue.” That’s a normal body response. Now, depending on the type of implant it can be or suture material or bit of shrapnel, whatever, your body will respond differently, and some things it really doesn’t like and it will just get this chronic aggravated information and chronic deposition of scar tissue, which builds up over time.
We know from various biotech materials that are being developed for bladders, that are being developed for cardiac, that are being developed in orthopaedics, everybody’s got the same issues in medicine. We want something that the body doesn’t get really antsy about it and puts too much scar tissue around.
Motiva have worked out based on good science and research that’s been done in biotech fields what kind of surface that cells are happy on. This will be the first of a generation of implants that we have a surface now that fibroblasts and inflammatory cells actually are not so reactive to, so they don’t respond with that big development of scar tissue, so you don’t get your capsulars.
Trish: Right, okay. How does inflammation affect the implants? Is that something that the surface helps with as well, then?
Dr. Corduff: Inflammation is like the key process that happens with anything in the body. You actually need inflammation to heal, which sounds bizarre to a lot of people, but you do. Inflammation is a word that describes the immune response and how the cells and the body’s defence systems work. If you get an angry chronic inflammation, it will just go on and on and on, and some kinds of information drives scar tissue deposition, and of course that’s what we get with capsulars in the breast implants.
Trish: Okay. What happens if an implant ruptures? What are Motiva rupture rates like, and how do they help safeguard against this, as well?
Dr. Corduff: Well, Motiva rupture rates are extremely low. They are way less 1%. The ruptures, actually, it’s very interesting. When you look at research that’s been done to ruptures, often it’s through a surgical injury to the implant where it’s been pushed through a tiny, tiny little hole when it doesn’t have the flexibility to get through that tiny, tiny hole because you’re always trying to keep the scar to a minimum for your patient. It can happen where it gets accidentally injured with surgical instrumentation, which of course can happen.
The other thing is just when the implant has got weaknesses in the shell, and Motiva have a shell designed that you can actually see with a blue layer, they can actually see if there’s any deficits in that shell, which is simple. I don’t know why nobody ever thought about it before. They have this blue layer so that when in inspection, they look for this blue layer and see if there’s any weaknesses or where the blue isn’t there and then if that’s the case, it gets rejected because that’s a spot of course where it can rupture.
That’s immediate rupture. Late rupture with time occurs just from wear and tear. If you’ve got an implant that has got wrinkles in it, the edges of the sides where the wrinkle is will gradually rub together over time and it will thin out, and then eventually you’ll get a breech and a rupture.
The other thing that can happen is the implants that you have that are really rough that adhere to the tissues, then you can get sort of a rupture because you get a tear, and it’s sort of hanging onto the tissues at one side and not on the other side, and that starts to rub and you get this friction and wear and tear from that area, too.
Motiva, one, it doesn’t adhere to the tissues. The capsule around a Motiva implant is quite different. It’s like a gossamer film. You don’t see the thick white tissue when you take them out. It’s just this transparent, tiny little filmy thing, so it’s hardly there. The gel has a different sort of technology in that it’s a lot more elastic. It’s more like, you know the mattresses that you get, the memory foam mattresses that you get that adapt to your body?
Trish: Mm-hmm (affirmative).
Dr. Corduff: Well, that’s how the gel has been designed in Motiva. It fits around the body shape and the movement. You’ve got to handle one to really get it, but it just feels quite different to other implants. That of course helps because the gel doesn’t run, doesn’t flow, but it just adapts into the body shape and it draws down and you don’t get those wrinkling problems, whereas the older gels would drop into the bottom.
Trish: Yes. It’s almost like implants haven’t changed for I think they said 30 years or something, and it’s basically been the same implants, so it’s almost like the world was ready for a next generation implant, really.
Dr. Corduff: I would disagree that things haven’t changed. I think we have changed and tried to work out new implants and had changes over the last 30 years, but we’ve always looked at implants and prosthetics from what we can see with our eyes and feel with our hands. This is the first time there’s been an implant developed that actually takes it right down to the cellular level and how cells will behave on an implant’s surface to actually prevent a lot of the problems that we have. It’s a completely different approach scientifically, and so that makes this a very novel development within implants and technology.
Trish: Yes. Women, they’re pretty active compared to 20 or 30 years ago. How has the technology with breast implants kept up with our changing lifestyle? I know that Motiva are known as being for the active woman.
Dr. Corduff: That is because it has a much softer feel, so it adapts with movement. It flows with the movement. The other thing is it doesn’t adhere to the tissues. It doesn’t stick, so it doesn’t pull. If you had the implants, which are the really rough-textured ones which are designed to stick to the tissues and hold them in place, it doesn’t move and it sticks, so then if you get really active and it’s under the muscle, you can actually get a tear and a localised bleed, and then you get a … and then you get a double capsular and then this ongoing increased inflammation causes problem, whereas of course if you don’t have a capsular and don’t have adherence to the breast tissues, it just flows and moves with the breast tissues naturally, you don’t get that problem.
Trish: Okay. With research of the brand of breast implants, why should women know or research which brand of breast implant they’re going to choose? I know for a fact, I speak to people all the time and they have no idea what’s in their breast.
Dr. Corduff: Yes. It is problem. There’s a huge choice. The science behind it is very, very complicated, and to be honest, I think it’s a little bit unfair to expect women to really know all the ins and outs of the breast implant technology and why which type would be better for them, et cetera. I think what I advise is that you do see a fully qualified plastic surgeon with an FRICS, has done the study and done the years and should know what the differences are and can look at you, assess you individually, and recommend what is best in your situation.
Trish: Yes, yes, totally agree. You’ve got to be wise who you go to, choose wisely.
Dr. Corduff: You’ve got to choose wisely. I think unfortunately, there are financial deals around and Groupon tickets and other things where you can get cheaper implants, cheaper surgery, and it is buyer beware. I’m sorry, but like with everything else, you get what you pay for.
Trish: That’s so true. That’s so true. Actually, I’ll talk about the types of implants. Which implant Motiva might suit a woman who’s wanting a natural result, something that feels and looks like a breast?
Dr. Corduff: Okay. They have a whole range, but in Australia, we have available the rounder, which is filled with the progressive plus gel, and we have the ergonomix. The progressive plus gel is slightly firm. It’s not as firm as some implants that are around, but it is slightly springier, I suppose is the best way to describe it. It’s still very soft, but it’s just got a little bit more spring to it, so it’ll just pop out that upper part of the breast a little bit more so you get that fullness, whereas the ergonomix is what I call a dynamic anatomical, so it just flows. You know those lava lamps from the ’70s? Remember those?
Trish: Mm-hmm (affirmative).
Dr. Corduff: That’s what ergonomix is like. It slowly oozes and drops into the shape that you want. As you move, whether you lie flat, the implants will flatten out. When you stand up, it will just slowly flow into the lower pole of the breast, so it is very much a natural appearance.
Trish: Okay, so that’s the ergonomix, more for someone wanting the natural result.
Dr. Corduff: Yes.
Trish: What about a woman wanting a fuller, rounder result? That would be the progressive?
Dr. Corduff: The progressive plus, yes.
Trish: Okay, right. Are they the only two implant types that there are?
Dr. Corduff: In Australia at the moment, yes, because it basically covers round and anatomical, because the ergonomix when you stand up becomes anatomical.
Trish: Yes. What happens when you’re lying at the beach? I’ve seen ladies lying at the beach and lying on their back and implants just sit upright.
Dr. Corduff: Yes, it doesn’t do that. It flattens out. It just softens out. As I say, if you imagine it like the lava lamps, that’s what it’s like.
Trish: Wow, wow, okay. Coming back to the pregnant woman or the woman having a baby, can women still breastfeed after having implants?
Dr. Corduff: Yes, absolutely. The problems with breastfeeding after implants is usually if the implant has been put through the nipple, which is extremely rare that we do these days for other reasons, but if you had to, that can be it because you can actually disrupt the surgical ducts. If you have to do a nipple correction at the same time, you’ll be coming through the ducts, but also, if the nipple’s become numb, like some women’s nerves don’t just come in through the side and around. They actually go out the back of the breast and up the middle, which is not the common type, but if you are that type, then the chances are that your nerves will be damaged during surgery and you will end up with a numb nipple. If you’ve got a numb nipple, the message doesn’t quite get to the brain to say, “Drop that milk.” That’s where problems can occur, but by far, the majority can breastfeed.
Trish: Okay, all right. How long after a breast augmentation can a woman start exercising?
Dr. Corduff: Okay, so that will depend a lot on how much work you’ve done within the operation. If you had to do a lot of supportive work, you want to get the support underneath the breast nice and strong before she starts bouncing. I think it’s bouncing that gives us the most grief because if you’ve got bouncing of a weight, which is a breast implant, onto where you’ve got a repair, then that can weaken it. We would usually say six to eight weeks with that, but they can do slow Pilates exercise pretty soon in. Again, it varies. There’s obviously a bit of variation depending on what exactly has been involved. If it’s a straightforward, very simple operation, then you can probably exercise quicker than the guy who needs to have a lot of work.
Trish: Yes, because I have heard a couple stories where people have gone and started actually lifting weights too soon after surgery. I don’t mean with the Motiva, but I’ve just heard as a general-
Dr. Corduff: Yes, it’s a general issue. It doesn’t matter. My protocol in my practise was four weeks in a sports bra completely, no bouncing, and then you can start doing some general exercise, but no bouncing for eight weeks, but you can do other exercises, but it’s just the bouncing. As the implant bounces down onto that wound, you don’t want that to happen.
Trish: Yes, okay. Yes, that makes so much sense. Just a last question before we finish off, because I know it’s getting late, but globally, what have the results been like with Motiva?
Dr. Corduff: Well, I’ll tell you a little story. There’s a guy who’s a plastic surgeon, a Brazilian guy who’s based in London. He works for one of these big clinic hospital groups. They started doing Motiva a few years ago and they’ve done over 12000 cases. In that hospital group, they have a situation where if you have any complication, any problem, you come back and it gets reoperated for free. Well, they dropped their reoperation rate from I think it was 7% right down to less than 1%, and the bean counters said, “You’ve got to switch over to Motiva.” This was during their trial when they were comparing them. The complication rate is less than 1%.
Trish: That’s fantastic. It’s a no brainer, really. I say that all the time, but it just seems like a no brainer. From what I’ve heard, if I was having implants tomorrow, I would only look at the Motiva ones. It’s just the fact that there’s all these little extras, even the fact that they’ve got those little microchips in them so that if something does happen down the track or whatever, you know exactly where your breast implant originated from, when it was put in. You’ve got the whole life story, hey?
Dr. Corduff: Yes, and the chip is actually incredibly useful. As a plastic surgeon and having been doing this for 30 years, you get a patient who comes in who’s had an implant in for years, they can’t remember, and I get it, but you can’t remember whether you’ve got saline or silicon, whether it’s textured, whether it’s smooth, what make it is, what size it is. You’re there running blind as a plastic surgeon thinking, “I’ve got to take this out and replace it. Do I just bring in the truck so I’ve got everything there? What are we dealing with here?” You’ve got no idea.
If you can just run a little scanner over it and it pops up and it says, “250CC implant, textured,” or, “Motiva, silk surface, put in blah blah,” you know exactly what you’re dealing with. You can just deal with it easy. It’s fantastic. Of course, if god forbid there’s a recall, like there was with the PIP, you can go in and see which batch number it is. Have you got a problem? No.
Trish: Exactly. You know exactly where it’s come from and exactly where it is. That’s so true. I get it, too, because I can’t even remember what I had for breakfast.
Dr. Corduff: You’re not the only one there.
Trish: That’s great. That’s been really, really helpful. Thank you so much for your time this evening, because I know it’s a bit late, but you guys are just so busy that it’s really hard to catch you at normal times.
Dr. Corduff: Sorry, Trish.
Trish: No, no, thank you so much.
Dr. Corduff: Yes, thank you.
Trish: No worries. Well, listen, if you’re out there and you’re thinking of getting breast implants done, definitely, definitely have a look at the options with the Motiva implants. You can find out a whole heap of information on our website or you can look them up. If you Google them, you can find them anyway, but if you have any other questions, just drop us an email to email@example.com. If you’d like to see or concert with Dr. Corduff, you can actually get in touch with her at the Cosmetic Refinement Clinic in Geelong. Thank you so much, Dr. Corduff.
Dr. Corduff: You’re very welcome, Trish.
Trish: Have a great night.
Dr. Corduff: And you too. Thank you.
Dr. Corduff: Bye.