BIONIC BREASTS Medical Vision Australia (MVA), Hackney, South Australia, is a trial sponsor for TriBreze titanium-coated breast implants (Poly Implants Prostheses — PIP). According to MVA, titanium is naturally present in human tissues, and is biologically inert: It does not induce inflammatory reactions and is not toxic to body tissues. This premise makes it an intriguing choice for implants.
The concept of using titanium in breast implants was supported by studies showing that titanium favored "some mature collagen at the implant surface; and researchers think that mature collagen could provoke less contractures than immature collagen," the MVA Web site explains.Researchers hypothesized that if collagen organization around an implant surface is linked to the collagen maturity, "one can think that the titanium coating would have a synergic effect to texture for a textured breast implant and a similar effect to texture for a smooth breast implant." PIP's position is that improving surface properties of the silicone breast implant envelope, "could decrease local complications linked to biological reactions occurring at the 'implant-tissue' interface of the patient (mostly capsular contractures)."
PIP has patented the titanium-coating process, and utilizes nanotechnology through the process of covalent bonding by molecular plaiting where silicone and titanium atoms are manipulated to create a new compound. Different than a simple coating, this creates a permanent physical bond (covalent bond) of the implant envelope with the titanium. This avoids the surface delaminating and increases durability of coating with time.
While Luiz Toledo, M.D., a plastic surgeon at the International Modern Hospital in Dubai, United Arab Emirates, doesn't have specific experience with titanium implants, he finds the concept intriguing. "The literature on gel cohesive implants with textured capsule is vast and the contracture minimal," he says but adds that, when he sees more scientific data on the titanium-coated implants, he may be interested in incorporating them into his practice.
Marita Eisenmann-Klein, M.D., practicing at Caritas Hospital St. Joseph, Regensburg, Germany, and secretary general for the International Confederation for Plastic Reconstructive and Aesthetic Surgery (IPRAS), has heard of titanium-coated implants, but has not personally used them. "I'm still collecting information," she says. She notes that several years ago, in Europe, there had been considerable advertising for titanium-coated implants, "but not anymore."
According to Stan Racic, managing director, MVA, titanium-coated silicone breast implants are currently in "clinical trial and we don't as yet have a full report on what the likely outcome will be. As much as we are very enthusiastic and very positive that this technology could make huge changes to women in the future, we cannot say that with any long-term authority at this point."
CUP HALF FILLED The use of hyaluronic acid (HA) as a filler is not a new concept to the world or to North America — but using it for breast augmentation may be.
Enter Macrolane VRF (Q-Med AB, Uppsala, Sweden), based on Q-Med's unique patented stabilized nonanimal hyaluronic acid (NASHA) technology. According to the International Macrolane Web site (which carries the specific disclaimer, "not intended for U.S. and Canada"), "Many physicians see advantages of using Macrolane for breast shaping as opposed to more invasive techniques," because it is less invasive than other surgeries — and its temporary nature can have advantages as well. "Macrolane is intended to last for at least a year. Each individual treatment program will include a yearly top-up as required to maintain optimal treatment results."