Trish: Well, hello everyone out there in podcast land. This is Trish from Transforming Bodies with Plastic Surgery Hub and I’m here today with Dr Scott Turner from all over Sydney actually. Dee Why, Northern Beaches … And Dr Turner is gonna talk to us today about the Motiva implants. He’s using them in his clinic and we’ve got lots of questions from patients so we’re gonna find out all about them.
So welcome Dr Turner.
Dr Scott Turner: Hi, and thanks for having me.
Trish: Yeah, thank you for coming along. Tell me, so you’ve decided … you are using Motiva implants in your clinic now. Can you tell us why? Why you decided to start using them?
Dr Scott Turner: Well, we’ve been using them probably for the last 18 months I suppose now, since they’ve come into the market in Australia. That was probably following a lot of the issues that have arisen about macro textured implants and it extends with ALCL or lymphoma in breast capsules that become more topical over the last 33 years. We’re always looking at, I suppose, how can we make our procedures more reliable, better outcomes, and safer. They’re a new implant on the market with a lot of science and technology behind it, which is quite impressive. So we decided to change, and we’ve been quite happy with the result we’ve had so far.
Trish: Oh great, because I know that they have been using them or testing them in Europe for over 10 years and we’re usually a little bit behind the eight-ball in getting stuff here, so there’s quite a bit of research behind them as you said.
Dr Scott Turner: Yeah, no. They’ve been using them for probably about 8-10 years now through Europe. They’re probably, I think realistically, I think now they’re the number one implant used throughout Europe, a lot of countries in Europe, because of the technology and the safety protocol associated with them. And when you speak to the guys over there that do a lot of it now, they will be quite happy with them. We went last year to Italy to the … Motiva had a conference. World of Ergonomics conference in Italy. They had a lot of people throughout Europe that have been using for the last 8-10 years talking about how they’ve been implemented in their practise, why they have changed, and why they continue to use them. And they had a lot of people from things like MIT talking about the technology, surface texturing, and how it relates to the way the body forms capsule and their concerns with things like ALCL and why Motiva with the nano-texturing is beneficial.
Trish: So tell me, are they pretty much suitable … are you using them for all your breast augmentations or are there some that … What I mean is do they have a nice variety of shapes and sizes, or are there some that you just can’t use before, like-
Dr Scott Turner: No, no. I think they’re pretty well covered now. As I said, we’ve probably used them for about 18 months. The first 6-12 months we used them sparingly. We used to use a lot of Mentor with the Siltex micro textured implant, and we used to use a lot of their anatomical devices. It’s only about the last six months that they have the health client rebate so if you use them for revealing procedure and process imageries, which is a lot of what we do. We’ll limit it for the first 6 or 9 months using them only for primary breast augmentation patients because, you know, you couldn’t get a rebate implants for the revision cases or breast asymmetry cases.
Now that’s changed, we’re using them for probably 90% of our breast implant patients. And I always say they’ve got a anatomical nano-textured implant which they’re hoping to bring to Australia. So once that comes out, this covers pretty much all breast augmentation patients. And this with the variation in the two different gels. So they’ve got the mix or the ultra, which is a softer gel. Which, especially when applied under the muscle, performs like an anatomical device, give you that natural high profile. Then they’ve got the progressive class, which is a slightly firmer, more cohesive gel. Which will give a more clean, which is a more traditional round shape.
So by adjusting the implant position, whether you put in front or below the muscle and the gel characteristics in which implant you choose, you can basically develop a very natural breast augmentation shape, or you can develop more of a slightly augmented or push up bra look.
Trish: Okay, so, depending on the implant you choose and the way you position it, depends on the look, the outcome as well and you-
Dr Scott Turner: Yeah, it’s a-
Trish: -can kind of achieve all those with the Motiva implants.
Dr Scott Turner: Yeah. A lot of people come in requesting a teardrop or an anatomical implant because they feel they’re gonna get a more natural result. That’s not always true. If you using a … especially a Motiva with a softer gel under the muscle, the result in shape of the breast will be almost identical to using a Mentor anatomical. Fairly real.
The advantage is, because it is a round device, there’s no risk of rotation. Rotation with anatomical implants is a big problem, you know. While primary rotation in that first couple of months after surgery is quite low, patients do come back one to five weeks down the track. They might’ve been playing sport or they’ve gone off and been doing some activity or had a car accident, and then they get a bit of swelling and then the breast implant rotates they can lose that adhesion between the implant and the capsule. But with a round device it doesn’t, there’s no worry.
And that’s one of the big problems with using macro-textured implants like Biocell, it’s that light seroma and double capsuling rotation that … It’s been a big issue over the last decade and caused a lot of revisions. You just don’t get that problem through the nano textured device, you don’t get light seromas, you don’t get double capsules so that’s not an anatomical device. You don’t get any rotation.
Trish: It’s a no brainer, really, isn’t it? To me, if you’ve gotta have implants, you wanna be sure that all that stuff’s not gonna happen. So if that’s …
Dr Scott Turner: Yeah. And I think over the last couple of decades, two or three decades ago, capsular contracture was the biggest concern with implants so high. And then the implants have got better, the surgeons have got better on setting up files and it’s improved and that technics have improved, the capsular contracture hasn’t been that much of a problem. And it’s the other thing that became an issue so, you know, people with seromas, implants rotating, asymmetries … They’re using an implant that’s more versatile, especially something like the Ergonomix because it’s the right … When you lie down it looks round, when you stand up it’s more teardrop, and if you lie on a bench the breast will fall to the side a little bit and give you more of a natural cleavage.
If you use quite a firm implant like an Allergan 410 implant, they’re quite firm gel so that there’s no movement in the gel of the implant, so it’s always the same position. It doesn’t behave like a breast normally does. A breast should fall to the side when you lie down, when you stand up it should droop a little bit.
Trish: Yeah. So is that like … Cause I know that the Motiva implants are a little bit … They cost a bit more than the other brands of implants. So that’s-
Dr Scott Turner: Yeah, it’s a minimal difference.
Dr Scott Turner: The difference in the cost between a teardrop shape or a Motiva is negligible. It’s about the same.
Dr Scott Turner: Using a simple round, it’s a few hundred dollars dearer. But when you look at the their capsular contracture rate, 8 or 10 years, it’s less than 2%. When you look at the core data for Mentor and Allergan the seven year guard for capsular contraction is over 10%. So reducing revision rate by two or three percent over ten years, the cost of a revision … You know, up next to a hundred or two hundred dollars for an implant, it really outweighs-
Trish: It’s so true. Yeah, cause the thing is, you’re gonna go through the surgery, you might as well have the best surgeon putting in the best implants really, hey?
Dr Scott Turner: Yeah, and this is what we tell people, that ideally you put an implant in there’s no reason that can’t last 20 or 30 years today. Cause the technology we have, the rupture rates are much, much lower than they were till three decades ago. If you can minimise capsular contracture and patient’s implant that helps you and they don’t have problems with stretching or relactation of the breasts after breastfeeding, there’s no reason that the implant you put can’t last two or three decades. Where in the 80’s and 90’s, if you had seven to ten years out of your breast implant you were doing well.
Trish: Yeah of course, that’s true. I just had a friend who had them removed about … Had her thirty-year-old implants removed about six months ago and they were a mess. I mean, she probably went ten years too long, but it was just like, a nightmare.
Anyway, so you’ve given us heaps of good information. Is there any one piece to take away that you would give to a woman who’s considering breast surgery with implants? Can you give us a take-away from Dr Turner?
Dr Scott Turner: The thing is, do your research, check who your surgeon is. I think that’s really important. I think see who you’re comfortable dealing with, cause when you see a surgeon you’re gonna have to see him multiple times and, I think, you’re gonna see him basically for life. We offer all our breast implantations for life so, you wanna find someone that you get along with, and you like, that you trust, and who’s gonna see you through for the next five, ten, fifteen, twenty years, before you might need a revision.
And that comes back to picking the implants based on true science, not just what looks on Instagram. There’s a lot of technology now with these newer implants around things like ALCL and breast lymphomas and capsular contracture and how it behaves, the tissue, how it behaves in the body.
Trish: Yeah. And they’re micro chipped as well, which means that you always know what you’ve had put in, so there’s no forgetting…
Dr Scott Turner: We have that all the time, people come in, they’ve had their implants ten years ago and they don’t remember which doctor put it in, they don’t remember what size it was. With these implants now we can scan the breast, ring up the company, and they’ll tell us who put it in or what size, what shape, what gel it was. And that makes doing revision sessions easier.
The new chips and the technology, they actually have sensors in them, built in, where you can detect temperature changes.
Trish: Get out.
Dr Scott Turner: And you can actually scan a breast and if one breast is hotter than the other, you can see whether there is an infection around an implant.
Trish: That’s amazing, that really is next generation implants, no doubt about it. Cause I know that nothing’s really changed for a lot of years and now Motiva have come on the market and things have kind of…
Dr Scott Turner: If you look at it from all other areas of surgery, if you look at Urology or Neurosurgery, all their catheters and tubings they use, they’re all nano textured.
Dr Scott Turner: None of them are smooth devices, none of them are macro textured, so the way that the cells interact with the nano texturing and how it responds and creates that scar tissue around it, is really important. And so, the technology and the implants that we’ve been using up to now have really been two decades out of date.
Trish: Yeah. Makes so much sense. Well I’m really excited, I mean, I was excited when I saw them for the first time, I thought “Ah, this just seem a little bit different”. The colour, the fact that they’ve got the microchips, the way they feel. So yeah, I’m a real supporter of the Motiva implants.
Thank you so much for your time today, really, really appreciate it.
Dr Scott Turner: No, thanks for having me.