When imagining the future, it’s hard not to conjure a world run by autonomous robots. But, emerging tech that paves the way for peak safety among breast surgery and augmentation patients isn’t what you’d think. While AI-powered robotic surgeries are touted as the next big thing for many medical specialties, such burgeoning automation only tacks more time and expense to breast procedures, according to Denver plastic surgeon Philippe A. Capraro, MD.
As for wearable tech and microchips made to monitor the health of the patient and breast implants themselves? Developers are working on them, but it’s still early days. “While not a replacement for clinical care, wearable monitoring could become a powerful companion, delivering personalized, data-informed recovery guided by real-time insight,” says Southfield, MI plastic surgeon Mariam Awada, MD. Ditto for chips that can detect when an implant has ruptured, a feature that could be particularly beneficial for those with silicone implants. “Most silicone implants are more like gel-filled gummy bear implants, so it’s very difficult to know whether an implant is broken,” adds Dr. Capraro. So which technologies pack the most promise for improved patient safety? It’s a mixture of the familiar and unimaginable that come with an added perk: the potential for more natural- looking results than we’ve ever seen.
Tracking + Traceability: Advanced Registries
For decades, those who received breast implants have literally become card-carrying members of the boob job club, thanks to registration cards that list information like implant type, manufacturer and batch number. This data is crucial for cross- checking against recalls, addressing complications or navigating tune-up appointments down the road. But, it’s also easily lost, should surgeons close practice, cards be misplaced or the manufacturer be forgotten.
That’s why companies are working to digitize such record keeping. One idea: installing RFID tags in the implants themselves, which is something Motiva has done with its Ergonomix2 implant, though it’s not approved for use in the United States. Similar to the tech used to track dogs, the tags—placed inside the gel filling of the implant—are programmed with identifying characteristics, such as implant style, volume and date of manufacture (and carry the potential to store additional information). Eugene, OR plastic surgeon Mark Jewell, MD, who has more than 45 years experience performing primary breast augmentation, calls the tech “potentially useful,” but has concerns of it being hacked, which could result in sensitive patient information being displayed online. “Most patients have their implant information in a registry that may be more secure,” he says.
Additionally, some researchers, like Sea Girt, NJ plastic surgeon Caroline Glicksman, MD—she serves as medical director for the U.S. Study of Effectiveness and Safety of Motiva’s SmoothSilk Ergonomix implants and holds a degree in pharmaceutical and medical device law—are concerned about the tag’s tendency to cause scatter in MRI imaging. This degrades image quality and can also impact the accuracy of readings. Instead, she says registries are, “the hottest new thing in patient safety.” These data registries, such as the National Breast Implant Registry (NBIR), offer a HIPAA-compliant way to store implant identification information. Should a patient lose their card, or their surgeon retire from practice, implant information can be accessed instantly, without having to bang down the manufacturer’s door.
The American Registry for Breast Implant Surveillance (ARISE), developed through The Aesthetic Society and The Aesthetic Foundation, takes the concept one step further with patient enrollment that creates a digital wallet with implant ID information and an operation report that includes procedure specifications, like the implant’s placement. This makes it possible to show an ER doctor, for example, implant and surgery details with the flash of a phone. ARISE also allows patients to securely and confidentially participate in prospective studies and is poised to push clinical research on breast implant surgery outcomes, such as complications and long-term effects, and ultimately improve patient safety. “I like ARISE because surgeons can connect and communicate directly with the patient, and no other registry does that,” Dr. Glicksman says. “Plus, it gives us access to trackable data from the day we put the implant in, which we can use for any studies we want to design.
Imagine breast enhancement or reconstruction where the final result is your own natural tissue.
Dr. Mariam Awada
The No-Implant Implant
Thanks to updated techniques (like dual-plane placement), tools (gel implants) and aesthetic trends (more natural-looking shapes), boob jobs are becoming more difficult to detect. Now, medtech firms are developing breast implants that are, themselves, designed to vanish.
Regenerative and aesthetic medicine companies like CollPlant Biotechnologies and BellaSeno are working on 3D-printed implants that grow natural breast tissue and degrade over time. BellaSeno is developing a 3D-printed polymer implant as an alternative to silicone. The resorbable breast scaffolds are inserted into the body, then populated with the patient’s own fat. “The fat lives and that scaffold helps achieve a natural appearance to the breast versus an amorphous blob of fat alone,” explains Dr. Jewell, who has advised BellaSeno. Over two or three years, the scaffolds resorb.
Although these scaffolds are meant to help breasts maintain shape, volume and softness, long-term results have yet to be seen. “Will the breast shape maintain its value without an outer shell?” asks La Jolla, CA plastic surgeon Robert Singer, MD. Then there are questions regarding the scaffold itself, and Dr. Capraro imagines consistent and full resorption of the scaffold will likely be required to avoid the formation of lumps. He is also interested in whether the degradation of the absorbable material will lead to increased calcification in the breast tissue. “That could be an issue when patients get mammograms. Now you have women getting biopsies because they see calcification on their breast,” Dr. Capraro says.
BellaSeno’s tech has been developed primarily for breast augmentation of cancer patients, and Dr. Jewell is encouraged by early research findings. “It looks promising for breast reconstruction or explantation because it gives shape and form to fat grafts that was not possible formerly with fat alone,” he says. “The availability of 3D-printed, absorbable breast forms allows for planning for surgery based upon patient measurements and tissue characteristics, similar to planning a breast augmentation for surgeons.” The bespoke nature of 3-D printing could make tomorrow’s breast augmentations the most natural-looking yet.
Dr. Singer says we are years away from knowing whether a disappearing implant can be swapped for the real thing. But should the tech pan out, we may see a future where no-implant implants eradicate complications like ruptures or capsular contracture, in which the formation of scar tissue causes the area around the implant to harden (and in some cases, the breast looks misshapen).
“This isn’t just innovation—it’s a paradigm shift,” says Dr. Awada. “Imagine breast enhancement or reconstruction where the final result is your own natural tissue, grown gradually and supported by dissolvable 3-D scaffolds and intelligent post-op care. Regenerative medicine has the potential to eliminate implant-related risks, reduce reoperations and deliver results that evolve with the patient, offering a future that’s safer, smarter and truly personalized.”
Using AI for Post- Surgery Predictions
Before-and-after images are a lynchpin of aesthetic medicine. But when it comes to visualizing personalized post-op results? That requires a degree of fantasy—or it used to anyway. Now, surgeons are adopting AI technologies to create lifelike simulations, predictive analytics and more.
Through tools like Natrelle 3D Visualizer, Crisalix and Vectra XT, 3-D imaging not only shows patients potential results of a breast surgery using their own likeness, but also helps surgeons explain exactly how the surgery will work while managing expectations. “Through vector 3-D imaging, we can basically simulate what an outcome could be, and it’s very accurate,” Dr. Glicksman says. “I’m not picking the implant by it, but I use it to educate the patient, such as showing their anatomy and chest wall asymmetries, and to make sure the patient and I are on the same page before surgery. It’s not as AI-intuitive yet, but I’m sure the tech will head in that direction.”
In an ideal world, plastic surgeons would walk every patient through the specifics of a procedure during consultations. “You’d be surprised how many physicians don’t even tell you half of what they’re going to do and how it will be done,” Dr. Capraro says. “Some patients might not even know where incisions will be made.” Aside from creating confusion for the patient, failing to provide thorough information could lead to potential lawsuits for the provider. Dr. Capraro uses AI tools during consultations to explain the entire procedure with the patient, which is something he finds, “very helpful in terms of comfort and emotional safety for the patient.”
Did You Know?
The Natrelle 3D Visualizer app allows breast augmentation patients to upload images of their body and “try on” the full INSPIRA collection from home. Mentor’s 3D Augmented Reality Breast Simulator app works similarly to help patients envision their new look and make informed decisions on their augmentation journey.
In-House Ultrasound Monitoring
Though companies are developing wearable tech to monitor pressure and patient temperature while in the recovery period following breast surgery, practicing breast augmentation specialists see more promise in a tried-and-true technology used to monitor recovery and progress: ultrasound. What’s so novel about such commonplace tech? How it’s being used by surgeons to boost patient safety. Instead of sending patients who experience post-op symptoms for an expensive MRI to collect imaging, surgeons now tap in-house ultrasound machines to get the data they need, fast.
“Probably our biggest advance lately is using ultrasound to evaluate breast implants, because it’s much more practical; it’s something we can do ourselves. You can literally get a device, hook it up to your cell phone or tablet and look at things in the office, whereas we used to have to send people to radiology to evaluate,” says Chicago plastic surgeon Michael Horn, MD. What’s more, ultrasound technology itself is advancing. “As that technology improves, we’ll be better able to detect [complications] sooner and easier,” Dr. Horn adds. “We’re also using it in surgery to see that we’re working at the right level without having to make an incision, for example. There’s a lot of potential with ultrasonic monitoring to help us do our job better and more safely.
