Dr. Leadbetter Ultrasound Interview:
Silicone gel breast implants offer women beautiful, natural-looking results from their breast augmentation. The silicone gel inside these implants is thick and sticky providing stability and natural movement. However, the stability also means that if a rupture occurs the silicone gel may stay close to the shell and not show physical symptoms of a rupture. The FDA recommends women with silicone gel breast implants get an MRI scan three-years after breast augmentation and then every twoyears for the life of their implants. Unfortunately, MRI scans are expensive and time-consuming and leading many women to put off their scans. We spoke to Dr. Michael Leadbetter, senior partner of The Plastic Surgery Group about a new easier option for silent rupture detection.
What Is High Resolution Ultrasound?
Ultrasound machines use non-invasive sound waves to create a real time picture of what is happening inside your body. New high-resolution technology is available making this picture clearer than ever, and allowing the surgeon to see breast implants specifically. Dr. Leadbetter has been on the forefront of this technology through his group’s involvement in a national research study. He explains his first impressions of high-resolution ultrasound (HRUS). “So far, I have been amazed at how well the resolution is. Obviously, there is a learning curve, and we are learning more and more as to what we are looking at, especially when we are dealing with the difference between smooth walled implants and textured surface implants. We are soon going to have a library here in the very near future that is going to give us the ability to pretty much evaluate anything that has to do with the implant.
Why Is Silent Rupture Detection Important?
Every woman has the right know what is happening inside her body. The patient should know about rupture so that they can decide how to move forward with their healthcare. According to Dr. Leadbetter, “Ultrasound, mammograms and MRI scans are imaging techniques that have been used over time to monitor our patients. These are very important diagnostic tools for following the health of women’s breasts and their implants. We do a tremendous volume of reconstruction, as well as cosmetic breast surgery, so we have thousands of implants that we have been following over the years.”
How Do Women Benefit from High Resolution Ultrasound vs. MRIs?
Why is high resolution ultrasound an exciting new development for women with silicone gel breast implants? Dr. Leadbetter tells us, “Recommendations from the FDA are to do MRI scans three-years after surgery and then every two-years thereafter; and mammograms when necessary. These are expensive tests, especially for younger woman who are not in the age group where mammograms are expected. So, to have a quick tool that can evaluate the breast on a convenient basis that is inexpensive and can be offered to our patients as they need it, is a tremendous benefit. So when we had the opportunity to take part in this national study, we jumped on that right away because we feel that this would be a tool in our practice that would be used to offer a noninvasive, inexpensive way of monitoring silicone gel implant, especially with the data that is coming out now about textured implants and helping patients with ALCL. Even though it is rare, people are still concerned. They just are very interested in knowing what the status of their implant is and if we can offer that to them, that is just a great bonus.”
“I make it very well aware to all of my patients that these are not lifetime implants and they have the potential to fail. So, the ability to evaluate them on an annual basis and catch a failure or a defect that can easily be taken care of, many times in the office under local anesthesia, is a huge bonus to these patients. So, I find that this does not scare the patients. They just look at this as a way for them to evaluate their implant and feel more secure with their implant in. So, I think at this point in time, it is a win/win situation for everybody.”
How Often Should Women Visit Their Surgeon To Evaluate Silent Rupture Detection?
Older implants have a statistically higher rate of rupture, but that does not mean newer implants cannot rupture. The truth is, breast implants, both old and new can rupture at any time. So, making time for regular checks with your surgeon is important. Dr. Leadbetter explains that at The Plastic Surgery Group, “I have been fortunate in that ever since I have been in practice, I recommend all of my silicone gel breast implant patients see me every year. When they have their mammograms done, I ask them to send the results of the mammograms. Now, in reality, if I am lucky, I get 50% of those women to follow up on a regular basis, but still, that is better than nothing. With the new ultrasound, we can actually communicate with our patient that there is something available to them that can easily evaluate their implant in the office in 15-minutes. The ability to do this becomes very important and encourages them to follow up routinely.”
How Do Patients Feel About Ultrasound For The Detection Of Silent Rupture?
How do Dr. Leadbetter’s patients respond to this new technology? According to him, every patient that has taken part said it has been great because it is very easy for them to do. They get to lay there and get to watch the exam live. So, they can see it on the I-Pad and they are fascinated with what they look at because they do not usually get a chance to see inside their breasts. All they could do was tell by how their breast implant feels. They do not know what this little bubble is or what that little wrinkle is, and it gives them the ability to understand by watching it live. So, I am sure, within the next year, we are going to have 100+, maybe more, that will take part with this because everybody has been very positive about it. They are going, “Oh, you mean I can do this while I am in the office, on an annual basis, in 15-minutes? I’m in!” So, I think that is going to be very important to them.”
Can High Resolution Ultrasound Help Women In Other Ways?
Recently, the FDA released information about a link between textured surface breast implants and BIA-ALCL. As Dr. Leadbetter mentioned above, he has always seen patients with concerns about their textured breast implants and ALCL. We asked how the recent FDA announcement has affected his practice. Dr. Leadbetter responded, “We are starting to see some of those patients now that the textured implant information has gotten out there. We are getting more people who are concerned about their implant, especially if they know it is textured.” I have always used smooth implants, pretty much, I would say, 85 to 90% of the time for all of my patients, except for postmastectomy reconstruction and in the very early years of BIOCELL implants from Allergan. So, very few of my primary augmentation patients have textured implants. Some of the patients recently being put in our study have textured implants in, and most of the early patients we enrolled in our study had smooth walled implants in. We are now starting to learn the slight, subtle changes that may be apparent with a textured implant, vs. a smooth implant, as more of the textured implant patients come in. So, I think it will be valuable to us. Will it change the way we approach textured implants, with everything that is out there now? “I am not sure it will change a whole lot, but it will still give the patient more data to help them make a decision about what they want to do.”
Visit Dr. Leadbetter and his Colleagues at The Plastic Surgery Group for evaluation of your breast implants. Dr. Leadbetter is one of the most experienced plastic surgeons in Cincinnati, Ohio and in the Crestview Hills, Kentucky area. At The Plastic Surgery Group, he offers the latest technology for safe and efficient cosmetic enhancement. To learn more about your options with breast implants, contact The Plastic Surgery Group today. Concerning breast implants in Cincinnati, Ohio or Crestview Hills, Kentucky, contact The Plastic Surgery Group today to discuss your options. Simply call 513-791-4440, or visit https:\\theplasticgroup.com. The offices are located at 4850 Red Bank Expressway, Cincinnati, OH 45227; and 340 Thomas Moore Parkway, Crestview Hills, KY 41017.