Implants in the News

Breast Augmentation Roundtable

Teitelbaum: Dr. Jewell, you are president of the largest aesthetic plastic surgery organization in the world, and education has not changed dramatically in recent time, and I still heard, as recently as yesterday, that people do not want it to be a changed standard of care. So it's still not happening. Explain to me how you believe what you are saying today, but yet.... Where is the obstruction to what you believe, that you just told us, being implemented?

Jewell: I do not know if it's necessarily obstruction to implementation as much as a problem with adaption. There are individuals who can adapt quickly to change. The vast majority, 75 percent of people, are either slow to late adaptors, are cautious and reticent to change. We made changes, for instance, in the S8 breast course curriculum here in New Orleans. We had longer presentations. We had in-depth discussions with regard to technique and technical factors.

Tebbetts: It strikes me as obvious that there is nothing wrong with a surgeon being insecure about doing something that the surgeon doesn't know how to do. It seems to me that that is in the best interest of the patient. So inherent to this entire discussion we are having is the premise that a surgeon shouldn't do what a surgeon doesn't know how to do, and that we must provide content that is verifiable, that is peer-reviewed, and that defines these processes, and we must do it really effectively. So, to make that really simple, we've got to give people not just a set of options; we have to tell people how to do this. The better the information we can provide, the more effectively we can deliver it. And to me, the answer is fairly clear: We simply haven't done that. We haven't done it effectively.

CONCLUSION

Teitelbaum: As we are getting ready to conclude, I want to see if you can agree with the conclusion I want to draw from what I've heard. The conclusion I would make is that we've all agreed that the standard of care has changed. Peer-reviewed published data and the results that all of you have described you are getting yourselves, since you've looked at your own results, which have made you face reality and make necessary changes, have proven that a new level of augmentation with lower reoperations is already possible. Does everybody agree with that?

All: Yes.

Adams: That's it, then. Thank you very much. I say we make that a consensus statement of this roundtable. I would like to, again, thank each of you for participating, and I think this will make a great addition to the upcoming supplement.

DISCLOSURES

Dr. Adams serves as medical director of the Mentor Corporation cohesive gel implant trial; an investigator for Allergan/Inamed/McGhan and Mentor cohesive gel IDE trials; an Allergan/Inamed/McGhan Academy faculty; and an Ethicon Innovation Council member. Dr. Teitelbaum receives travel expenses and a stipend for teaching from Inamed; he also receives office expense reimbursement for conducting clinical trials of cohesive gel implants from Inamed, Mentor, and Silimed. Dr. Bengtson is an active participant in both Mentor and Inamed's adjunct silicone implant studies, is one of the lead investigators for Inamed's Style 410 cohesive gel implant study, and receives nominal fees to help administrate and offset the Style 410 implant study; he has participated in Allergan/Inamed/McGhan Academy teaching courses and received a stipend for his time and travel. He is not a consultant and has no patents, financial interest, or stock or equity interest in any implant company. Dr. Jewell is an approved clinical investigator for Allergan/Inamed/McGhan and Mentor gel studies (Allergan/Inamed/McGhan Core and Style 410; Mentor CPG); he has received a small stipend from both companies to compensate administrative staff time regarding clinical follow-up and medical records administrative activities. A member of Dr. Tebbetts' family is an employee of a business entity that receives consulting fees and product royalty payments for products designed by the author from Allergan/Inamed/McGhan Corporation and Cardinal Snowden Pencer Corporation. Dr. Spear is a consultant to Lifecell, Ethicon, and Allergan/Inamed/McGhan corporations

Read the entire breast augmentation discussion.

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