Adjustable Silicone Gel Breast Implants

Selecting an Implant - Filling Adjustable Gel Implants - Textured vs Smooth Implants

The Spectra Adjustable Gel Implant

The Spectra adjustable gel breast implant is essentially a unique gel implant having a small inner chamber that can be filled with variable amounts of saline or left completely empty. The inner chamber can be over filled to give increased projection without palpable firmness. The additional volume causes minimal change in base diameter.

The Spectra Adjustable Gel implant was developed by Dr. Becker in 2006.

Fill tube removed no saline added.

Fill tube removed when correct
volume of saleine is added.

Injection dome attached to fill tube.
saline added post-opperative via injection
dome and fill tube removed when correct
volume and projection is obtained.

Indications

Breast augmentation
- For post operative volume and projection adjustment.
- Assymmetry
- Mild ptosis correction
- Enhanced projection
Augmentation Mastopexy
- For optimal volume and projection
- To enhance projection with circum areolar mastopexy
Revision augmentation
- Where some expansion is required
Breast Reconstruction
- As a second stage replacement following expander removal
- Immediate one stage reconstruction following skin sparring mastectomy
- Delayed reconstruction – For enhanced projection
- Delayed reconstruction where a reduction or augmentation will be done on the opposite breast. Post operative adjustment aids in achievement of asymmetry.
- Revision reconstruction requiring tissue shaping and symmetry.
Congenital anomalies
- Correction of Poland’s syndrome where the final implant is required to be a gel
- Prevention and Treatment of Capsular Contraction
- Replacement of Saline implants or gel implants where rippling has been a problem

Selecting Breast Implant Size

3 parameters have to be matched:

Base Diameter
Volume
Projection

However for a fixed volume, base diameter decreases with increasing projection. Therefore it may not always be possible to match base diameter volume & projection with a fixed volume implant.

Adjustable Gel Implant allows for increased projection without reducing base diameter.

When selecting a breast implant the surgeon measures the base diameter. The patient usually has an idea of the volume she would like to have. The base diameter and the volume have been matched by increasing or decreasing for a fixed volume. The base diameter decreases with increasing projection. Therefore if the patient chooses a 250 cc volume that her based diameter is 12.7. Projection has to be compromised and a low profile implant needs to be selected.

Human tissue is flexible and even if the correct size and diameter has been selected post operative changes take place due to molding of the tissues. This can be seen in this patient where the implant has been removed and chest wall recession was noted.

The Spectra Adjustable Gel Implant has a small inner lumen which can remain completely devoid of saline and function as a regular gel implant. However, should increase volume or projection be required this can be done without significantly changing the base diameter. The inner lumen can be partially filled or even overfilled. Once the desired projection and volume and been obtained the fill tube is simple removed.

By having the ability to alter the volume and the projection with a fixed diameter the surgeon can more accurately correct ptosis, asymmetry, match the patients desire can compensate for chest wall deformity.

Filling Adjustable Gel Breast Implants

Intra Operative

Post Operative External Injection Dome

Post Operative Buried Injection Domes

Base diameter does not decrease with increased projection

Base Diameter	Volume	Projection
11cm	285cc	3.1cm
	325cc	4.7cm

12cm	355cc	3.5cm
	395cc	5.0cm

13.2cm	480cc	3.9cm
	540cc	5.4cm

Inner lumen may remain empty, or overfilled to 2-3 times the recommended volume.

The fill volumes on the implant brochures are not clinically determined. The optimal fill volume is the volume of the Mandril used to manufacture the implant. Minimal fill volume is determined by removing fluid from an optimally filled implant until “significant” rippling occurs. Maximal fill volume represents the point at which overfilling causes scalloping.

Clinically it is known that underfilling leads to a higher leakage rate. No increased leakage as a result of moderate overfilling has been documented.

Textured implants – Saline or gel saline should be filled to the optimal fill volume to reduce the occurrence of rippling or scalloping. Rippling or scalloping is seen less commonly with smooth implants and in implants with a higher gel volume.

The adjustable gel(Spectra) has a different response. Underfilling is not possible as the gel volume is that of a regular gel implant. On overfilling the implant no scalloping is seen.