When imagining the future, it is difficult to remember a world run by autonomous robots. But new techniques that pave the way for a peak of safety among breast surgery and augmentation patients are not what you think. According to Philip A. Capraro, MD, a plastic surgeon in Denver, AI-powered robotic surgery is touted as the next big part of many medical specialties, but the burgeoning automation only costs more time and money on breast procedures.
What about wearable technologies and microchips made to monitor the health of patients and breast implants? Developers are working on them, but that’s still early on. “While it’s not an alternative to clinical care, wearable surveillance could become a powerful companion and provide recovery based on personalized data guided by real-time insights,” similar to the chips that can be detected when an implant ruptures. This is a particularly beneficial feature for those with silicone implants. “Most silicone implants resemble gummy bare implants filled with gel, so it’s very difficult to know if an implant is broken,” adds Dr. Capraro. So, which technology packs the most promising things to improve patient safety? It’s a mixture of familiar and imaginative things that come with the added perks. It’s a more natural possibility of results than ever before.
Tracking + Traceability: Advanced Registry
For decades, those who received breast implants have become literally members carrying cards for The Boob Job Club, thanks to a registration card listing information such as implant type, manufacturer, batch number and more. This data is essential for cross-checking recalls, dealing with complications, or navigation of appointments for future adjustments. However, if the surgeon practices closely, leaves a card or forgets the maker, it is easily lost.
That’s why companies are working to digitalize such record keeping. One idea is to install the RFID tag on the implant itself. This is what Motiva did with Ergonomicx2 implants, but has not been approved for use in the US. Similar to the techniques used to track dogs, tags placed within the implant’s gel filling programmed discriminant properties (and may store additional information) such as implant style, volume, and production date. Eugene, or plastic surgeon Mark Jewel, Maryland, who has over 45 years of experience in major breast augmentation, calls the technique “potentially useful,” but there are concerns that it is being hacked and confidential patient information may be displayed online. “Most patients have implant information in a registry that may be safer,” he says.
Additionally, researchers such as New Jersey plastic surgeon Caroline Glicksman, Maryland, and others are medical directors for US research on the efficacy and safety of Motiva’s Smooth Silk Ergonomicx implants, and hold a degree in drug and medical device law. This can reduce image quality and affect the accuracy of the measurements. Instead, she says the registry is “the hottest newest thing in patient safety.” These data registries provide HIPAA-compliant methods for storing implant identification information, such as the National Breast Implant Registry (NBIR). If a patient loses a card or the surgeon retires from practice, you can access implant information instantly without knocking on the manufacturer’s door.
Developed through aesthetic society and aesthetic foundations, the American Breast Implant Monitoring Registration (ARISE) is one step further by registering patients to create digital wallets with implant ID information and those to create operational reports including procedure specifications such as implant placement. This allows you to show your ER doctor, for example, a cell phone flash, such as implants and surgical details. It also allows patients to participate safely and confidentially in prospective research, promote clinical research into breast implant surgery outcomes, including complications and long-term effects, and is positioned to ultimately improve patient safety. “I like it because surgeons can connect directly with patients and communicate directly. Other registries don’t,” says Dr. Glicksman. “In addition, it provides access to trackable data from the day the implant is placed, which can be used for the research you want to design.
If the final result is your own natural tissue, imagine strengthening or reconstructing the breast.
Dr. Mariam Awada
Implant-free implants
Thanks to updated techniques (such as dual-plane placement), tools (gel implants), and aesthetic trends (more natural appearance shapes), boob jobs are becoming more difficult to detect. Today, MedTech companies are developing breast implants designed to disappear in their own right.
Regenerative and aesthetic healthcare companies such as Collplant Biotechnologies and Bellaseno grow natural breast tissue and tackle 3D printed implants that deteriorate over time. Veraceno is developing 3D printed polymer implants as an alternative to silicon. The absorbable breast scaffold is inserted into the body and contains the patient’s own fat. “Fat is born, and its scaffolding helps achieve a natural look in the chest and achieve a fat-only amorphous mass,” explains Dr. Jewel, who advised Veraceno. The scaffolding will adsorb for two or three years.
These scaffolds are intended to help the breast maintain shape, volume and softness, but long-term results have not been seen yet. “Does the shape of the breast maintain its value without the outer shell?” asks California plastic surgeon Robert Singer, La Jolla, Maryland. Next, there is a question about the scaffold itself, and Dr. Capraro imagines that consistent and complete absorption of the scaffold will be required to avoid mass formation. He is also interested in whether degradation of absorbable materials leads to increased calcification of breast tissue. “If a patient takes a mammogram, that can be a problem. Now there are women who are undergoing biopsies because they have calcification in their breasts,” says Dr. Capraro.
Bellaseno’s technology has been developed primarily for breast augmentation in cancer patients, and Dr. Jewell is encouraged by early research findings. “Breast reconstruction and explantation look promising as it gives shape and shape to fat grafts that were previously impossible to do with fat alone,” he says. “The availability of 3D printed, absorbable breast morphology allows for planning surgery based on patient measurements and tissue characteristics, just like surgeons’ breast augmentation plans.” The bespoke nature of 3D printed allows tomorrow’s breast augmentation to look the most natural to date.
Dr. Singer says we have been away for years from knowing whether we can replace the disappearing implants for the real thing. However, if high-tech pans, we may see a future in which implants will eradicate complications such as rupture and capsular contractures. There, the formation of scar tissue stiffens the area around the implant (and in some cases the breast appears to be incorrect).
“This is not just an innovation, it’s a paradigm shift,” says Dr. Awada. “Imagine strengthening or reconstructing your breast, your own natural tissue, supported by lysable 3D scaffolds and intelligent postoperative care. Regenerative medicine can eliminate implant-related risks, reduce resurgence, and bring about evolving results with patients.
Use AI for post-surgery predictions
The images before and after are lynchpin, an aesthetic drug. But what about visualizing personalized postoperative results? That requires some degree of fantasy. Currently, surgeons employ AI technology to create realistic simulations, predictive analytics and more.
Through tools such as Natrelle 3D Visualizer, Crisalix, Vectra XT, and 3D imaging, it not only helps patients use their likeness to show potential outcomes of breast surgery, but also helps surgeons to explain exactly how the surgery works while managing their expectations. “Through vector 3D imaging, you can basically simulate what the outcome is. That’s very accurate,” says Dr. Glicksman. “I don’t choose implants by that, but I use them to educate the patient, such as showing anatomy and chest wall asymmetry, and make sure the patient and I are on the same page before the surgery.
In an ideal world, plastic surgeons will walk through the details of the procedure during consultations with all patients. “You’ll be surprised at how many doctors don’t even tell you what you’re trying to do or half of how it’s done,” says Dr. Capraro. “Some patients may not even know where the incision will be made.” Aside from causing patient confusion, failure to provide thorough information could lead to potential lawsuits for healthcare providers. Dr. Capraro uses AI tools during consultations to explain the entire procedure with the patient. This is “very helpful in terms of patient comfort and emotional safety.”
Did you know?
The Natrelle 3D Visualizer app allows breast augmentation patients to upload images of their bodies and “try” the complete Inspira collection from home. The Mentor’s 3D Augmented Reality Breast Augmented Simulator app works similarly, helping patients to assume a new look and make informed decisions on their augmentation journey.
In-house ultrasound monitoring
While companies are developing wearable technologies to monitor pressure and patient temperature during recovery periods after breast surgery, the practice of breast augmentation experts sees more promise with proven techniques used to monitor recovery and progression: ultrasound. What’s so novel about these general techniques? How surgeons are used to improve patient safety. Instead of sending patients experiencing expensive MRI postoperative symptoms to collect imaging, surgeons tap on their in-house ultrasound machine to quickly retrieve the required data.
“Perhaps the biggest advancement these days is to evaluate breast implants using ultrasound because it’s much more practical. That’s what we can do. You can literally get a device, connect it to a phone or tablet and see things in the office. What’s more, ultrasound technology itself is advancing. “As that technology improves, it’s easier to detect (complications) than that,” adds Dr. Horn. “We also found that we work at the right level without making incisions, for example, and there are many possibilities for ultrasound monitoring that will help us do our work better and safer.
