Is There Really Such a Thing as Injectable Breast Implants?
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For some of us, cosmetic injections are a way of life: a little Botox touch-up here, some hyaluronic acid filler there, brows are lifted, lines are erased. It’s never been easier or more convenient to tweak your appearance—and now the enhancement-by-syringe approach is moving to breasts.
Mia Femtech—the so-called “injectable breast implant”—is already in use overseas, including in Japan, Sweden, Dubai, Switzerland, and Spain. It’s basically supposed to offer a breast augmentation lite: The idea is that you can go up one to two cup sizes with a quick 15- to 90-minute procedure. There’s supposed to be minimal scarring (in the armpits), no recovery time to speak of, and no need for general anesthesia (just local anesthetic, or “numbing shots”). This is a huge departure from typical breast augmentation procedures, which usually entail general anesthesia, scars under the curve of the breast, and bruising for about three to four weeks.
We had to know more: Are “injectable breast implants” a game changer or too good to be true? And when might this procedure be approved by the FDA?
Meet the experts:
Charles Randquist, MD, is a board-certified plastic surgeon in Sweden, Germany, and Spain and helped create the Mia Femtech technology
Kamakshi Zeidler, MD, is a board-certified plastic surgeon in Campbell, California and a member of the Motiva Femtech Board
Peter Lee, MD, is a board-certified plastic surgeon in Los Angeles
Roy Kim, MD, is a board-certified plastic surgeon in San Francisco
Melissa Doft, MD, is a board-certified plastic surgeon in New York City
What is injectable breast augmentation?
The phrase “injectable breast implants” is definitely attention grabbing, but this isn’t the first time there’s been talk of injectable augmentation. “Many moons ago, about 15 years, I was training plastic surgeons in Southeast Asia, [where the gel] hyaluronic acid injectable Macrolane was used [to augment] the breasts,” says Charles Randquist, MD, a board-certified plastic surgeon in Sweden, Germany, and Spain who helped create Mia Femtech. The problem was Macrolane also created nodules that interfered with breast cancer screening. “For me, it was absolute madness what was going on—I said, ‘No, this is wrong,’” says Dr. Randquist. Macrolane wasn’t only used in the breasts in Asia. Created by a Swedish company, it became available in France in 2007 and was approved for breast augmentation throughout Europe in 2008. Four years later, it was taken off the worldwide breast augmentation market because of the way it complicated breast cancer screening.
So the first thing to know about Mia Femtech is that it is most definitely not a hyaluronic acid injectable—it’s not filler, it’s not Botox, it’s not PRP, it’s not Sculptra. Instead, Mia Femtech is a new kind of silicone implant that is squishy enough to be inserted through a very small (approximately two centimeter) incision made in an inconspicuous place: the axilla, aka the armpit. Local anesthesia is administered, a small surgical tool (called a dissector) creates a narrow tunnel from the armpit to the center of the breast, and the Mia Femtech implant travels to the breast through that tunnel. It’s not actually injected with a needle, but the implant does travel via an air-powered injection port to its destination: above the muscle in the breast.
What’s unique about the implant itself is that it’s elastic enough to be compressed through the injection port, and then regain its shape once it reaches the breast, explains Dr. Randquist. (Traditional silicone implants weren’t flexible enough to make the journey—“they broke,” he says). The whole system took about six years to develop. The silicone implant is basically “sucked through” the injection port “like a straw,” explains Kamakshi Zeidler, MD, a California-based, board-certified plastic surgeon who sits on the Mia Femtech board. Because the implant is injected in a closed system, it is “never handled directly by the surgeon,” which can reduce the risk of infection, says Peter Lee, MD, a board-certified plastic surgeon in Los Angeles.
“Injectable breast implant” does sound intriguing—and potentially a bit confounding—but delivering an implant through the armpit isn’t unheard of in the US. “This is similar to an underarm breast augmentation,” says Roy Kim, MD, a board-certified plastic surgeon in San Francisco. During that procedure, which plastic surgeons call transaxillary breast augmentation, an underarm incision about four to seven inches long is made, and a “breast sizer” is introduced through the incision. The tool is expanded, deflated, and removed before a saline implant is inserted in the breast using a Keller funnel, which is a cone-shaped device that looks similar to a pastry-decorating bag.
One of the biggest differences between transaxillary breast augmentation and Mia Femtech has to do with the implant itself: Transaxillary breast augmentation uses a saline implant, while Mia Femtech’s is silicone. That matters because silicone implants are less likely to ripple than saline implants are—and when rippling shows through the skin, implants look unnatural, says Dr. Lee.
The shape of the Mia Femtech implant is also unique: Instead of a flat back and rounded front, Mia Femtech is diamond-like. It’s made that way so it can “nest into tissue” while giving a small volume boost, says Dr. Zeidler. And it yields a different final result—more volume in the center of the breast, versus fullness allover.
That small volume boost can take a patient up a cup size or two—it’s more like the oomph you’d get from a push-up bra or padded bikini top than the volume enhancement you might associate with breast augmentation. “For patients who want a larger cup increase, upper pole [cleavage] fullness, or who have thin skin, a traditionally shaped implant would be superior,” says Melissa Doft, MD, a board-certified plastic surgeon in New York City. Those have a larger diameter, allowing for more fullness and cleavage, and can be placed below the muscle, so you don’t see the implant’s edges through thin skin.
So if you’re looking to change the shape or size of your breasts, Mia Femtech is probably not for you. “It's more, ‘It'd be nice to just live without a padded bra’ or to be able to wear bathing suits or athletic wear and not feel like you're just completely flat,” says Dr. Zeidler. Because Mia Femtech doesn’t give you a lift, it’s also not the best solution for someone looking for a “mommy makeover,” which often includes a breast lift (mastopexy).
What are the risks of injectable breast implants?
The risks are similar to that of a traditional augmentation procedure, says Dr. Doft. They include bleeding, infection, asymmetry, malposition of the implant, rupture of the implant, and capsular contracture, or hard, misshapen breasts. In a study of 100 patients done by Establishment Labs, the parent company of Mia Femtech, there were no reports of capsular contracture, rupture, infection, “bottoming out” (when implants drift down and outward because of muscle contraction), inflammatory reaction, tissue damage or necrosis, or hematoma. Recovery-wise, Mia Femtech says that patients can go back to their day-to-day life immediately, with a two-week break from exercise.
That’s not to say that this procedure is a proverbial walk in the park compared to a traditional augmentation. One risk could center around the surgical “pocket,” or the place where the implant is inserted into the body, says Dr. Kim, who is familiar with Mia Femtech but hasn’t used it himself. He does, however, perform traditional underarm breast augmentation. In those operations, “I just want to make that pocket perfect—it has to ‘fit’ the implant... or the implant will slide to the underarm or to the collarbones when the patient is lying flat or not move normally... If you're not happy with the pocket, best of luck trying to fix it with this limited instrumentation.” He also notes that it can be difficult to control bleeding with an underarm incision. If something were to go wrong, Dr. Zeidler says, a doctor would have to convert to an open procedure. Which leads us to…
The medspa-ification of breast augmentation
Given the marketing-friendly idea of “injectable implants,” it’s not outside the realm of possibility to think it could catch on with medspas who are looking to expand their slate of services— an idea that raises some eyebrows from doctors. “Placing it in a medical spa would be quite scary,” says Dr. Doft. “This is still a surgical procedure—it would have to be performed in an operating room by a surgeon.”
Dr. Zeidler agrees. “This is a much more significant procedure than facial filler—and many of us think there's significant risk there,” she says. “I don't see this falling outside the realm of the plastic surgeon.” She does, however, think it may open doors for more similar, “non-surgical” innovations.
Some med spas in the US are already injecting PRP, patients' own platelet-rich plasma, and Sculptra, a biostimulatory filler that triggers collagen productions, in controversial techniques that may be marketed as “liquid breast enhancement” with questionable promises of lifting or volumizing.
If Mia Femtech is approved by the FDA, Dr. Kim wouldn’t be surprised to see it come to life via Mia Femtech-specific chains. Dr. Lee thinks it would be comparable to what currently exists in Europe: a franchise model where the company educates physician trainers who then teach and certify qualified practitioners.
But will the FDA—whose famously high, strict standards for approval of new fillers and surgical devices often require months if not years of testing—ever approve Mia Femtech in the United States? “It may,” says Dr. Doft, citing the similarities to the existing underarm method of breast augmentation. Dr. Lee shares that some forecast FDA approval within a year. Establishment Labs did not comment on a predicted timeline.
To read more about breast augmentation:
The Makings of a Modern Boob Job
Breast Lifts Are on the Way Up
Now watch Cindy Crawford's 10-minute beauty routine:
Originally Appeared on Allure
