Natrelle implants are designed and tested to deliver lasting shape, high satisfaction and minimal risk of complication.

Confidence and sustainability are synonymous with Allergan breast implants. At the forefront of today’s breast surgery technology, Allergan’s Natrelle implant range is the result of 25 years of experience and development.

Natrelle implants are meticulously designed and tested to deliver lasting shape, high satisfaction and minimal risk of complication
to breast augmentation patients. Natrelle implants are made at a state-of-the-art facility and undergo almost 100 quality control tests, including rupture resistance and shell integrity.

From start to finish, it can take up to 12 days to manufacture a Natrelle breast implant. These standards mean that every implant produced is thoroughly evaluated for quality and durability, greatly reducing the possibility of complications.

Allergan has been a global leader in science and medical innovation for over 50 years – and in the breast aesthetics for more than 30 years. With an excellent safety protocol and over 500 breast implant selections the Natrelle Collection available in Australia, they offer a quality, customised approach.

The Natrelle range includes smooth and textured gel implants in both round and teardrop shapes. The extensive variety of breast width, projection and volume (from 110 grams to 800 grams) options helps in tailoring surgery to suits your patients’ needs, expectations and existing anatomy.

Safety comes first

Natrelle implants are designed with Biocell® macrotextured surface – featuring open pore texturisation and variable distribution of depressions on the surface. The textured surface helps counter the risk of malposition and rippling, and also reduces the risk of capsular contracture.

Research by Maxwell et al* looked into the safety and effectiveness of Natrelle implants over six years. The prospective multicentre study involved 941 patients.

“The rates for capsular contracture among augmentations and revision augmentations were significantly lower with the Natrelle 410 implants than with other surgical gel implants,” the report states. “The satisfaction rate [measured on a five-point scale] exceeded 80 percent in all cohorts.”

Additionally, all Allergan gel-filled breast implants have a patented intrashiel® Barrier Technology. This barrier in the shell reduces shell permeability and minimises gel diffusion or gel bleed.

One European study, referred to as the International MRI Study**, examined silent rupture data on 77 augmentation, 11 reconstruction and 18 revision patients implanted with smooth and textured Natrelle implants. The average age of implant was 11 years and the study found silent rupture in approximately 15 percent of the combined group of augmentation, reconstruction and revision patients.

Patient satisfaction

A core study conducted by Allergan, published in 2009, looked into the safety and effectiveness of Natrelle implants. The study enrolled 455 breast augmentation patients, most of who were treated with smooth, gel-filled implants. Patient satisfaction was based on a five- point scale assessment and tested at seven years post-operation.

Of the original 455 patients, 317 (70 percent) underwent satisfaction testing. In this group, 95 percent of patients indicated they were satisfied with their breast implants after seven years.

A similar study, published in 2014, was conducted using anatomically shaped, silicone-filled Natrelle breast implants. Of the original 492 patients, 292 participated in satisfaction at 10 years after implantation. Of these, 89 percent indicated they were definitely satisfied with their breast implants at a decade post-procedure.

The Natrelle range offers all the implant options you need for your breast augmentation and reconstruction patients. The extensive variety of breast width, projection and volume options gives you a customisable advantage, assisting in tailoring surgery to suit your patients’ needs, expectations and existing anatomy.

Shape that holds

The Natrelle Collection incorporates three types of silicone gel filling, plus a dual gel for extra firmness. The highly cohesive gel
is designed to prevent downward migration and maintain upper pole fill and shape over time.

TruForm 1
Responsive gel: The softest cohesive gel

TruForm 2
Soft-touch gel: A slightly firmer cohesive gel offering shape control with natural movement and feeling

TruForm 3
Cohesive gel: A higher cohesive gel for shape and control

TruForm
Firm cohesive gel: This is a dual gel, used for an even firmer cohesive gel on the anterior portion of Natrelle 510

Q&A with Melbourne Plastic Surgeon Dr Graeme Southwick

Q: What’s been your experience using Natrelle implants?GraemeSouthwick

A: I’ve been using Natrelle implants since they were introduced into Australia [2001]. I’m happy with the thicker outer shell and consistency of the contained gel.

I have used many implant types over my 37 years’ experience in the private and public hospital arena and have noted many, particularly earlier silicone implant types, with weak outer shells and poor silicone gel consistency. This is not so important in the early patient history but especially so in long-term patient follow-up – some are over 20 years after implantation.

Rupture and leakage in my view is an inevitability long term and should be planned for – I have always tried to follow my patients every 12–18 months both clinically and with ultrasound and see implant issues arising commonly (occasionally as early as six years but often after 10 years).

Removal should be easy but if the gel has poor cohesive properties at body temperature then spillage is common and surgery to remove and replace is more technically difficult.

I have found the Allergan implants to be usually of good consistency at removal.

Rippling with all implants can be an issue, especially in the thin, small-breasted augment patient – although it occurs, I have found this to be minimal with the Natrelle implants.

My Baker 3 and 4 capsule rate is minimal and average as per published figures.

Patient feedback, both short term and long term, is excellent.

Q: What is your preferred shape and texture?
A: Round smooth (TruForm 2) implant placed in a subpectoral pocket.

Q: Do you have any tips for your colleagues on how you use Natrelle implants?
A: All implants can be damaged on insertion. I recommend a 4cm incision just above the proposed inframammary crease line (this negates scar visibility when patients raise their arms in a bikini which could reveal the scar) and placing it just lateral to the midline for ease of access to the pectoralis inferolateral free border.

Transaxillary incision (with or without endoscopic assistance) is also useful but has less refined and controlled lower hemibreast pocket control.

I avoid periareolar access as dissection affects parenchymal architecture which may have long- term consequences.

If a concurrent mastopexy is planned then I use the vertical infra-areolar incision as the access. I recommend a spacious pocket but well controlled, especially medially where pectoralis fascia must be preserved, at the inframammary crease (the SFS is reconstituted
on closure), and dissect the lateral 76 pocket extent last to prevent lateral malposition of the implant.

Like all implants, insertion technique is important as intra-gel rupture leads to implant deformity. The Keller funnel is useful, but careful attention to avoid undue implant shell distortion on insertion is also key.

Natrelle implant gel consistency gives a better degree of safety at insertion compared with others I have used. Of course, use of antibiotics, implant and cavity bathing, glove change and nipple shielding are essential at insertion of any implant. Drain tubes are not routinely used.

Q: What’s your experience dealing with Allergan, in terms of service and support?
A: Supply chain has been excellent and only rarely has a particular size been on back-order. I always order a back-up implant and, on the rare occasion it has been necessary to use it (usually in training purposes), I have found Allergan to be very supportive. A sizer implant has always accompanied the implants, which I have found most useful. The Allergan rupture warranty has always been adhered to by the company without question. Allergan has consistently been a company supportive of plastic surgeons, their trainees, plastic surgeon fellows and our education meetings – although I have no financial disclosure regarding Allergan and its Natrelle product, I have been very appreciative of the ongoing sponsorship given to the not-for-profit Advanced Aesthetic Plastic Surgery Workshop held each February in Melbourne hosted by The Melbourne Institute of Plastic Surgery and also to Allergan’s trade relationship with our plastic surgery Societies – ASAPS and ASPS.

Q&A with Melbourne Plastic Surgeon Dr Craig Layt
LAYT-MAY-2015-(161-of-1124)

Q: What’s been your experience using Natrelle? A: I have been using Natrelle implants since their introduction to Australia in 2001.

Natrelle implants are offered in four different levels: TruForm 1, 2 and 3 and dual gel (510). The Inspira round comes in Truform 1 and 2, the 410 in Truform 2 and 3 and the 510 in the dual gel. The fact that the Inspira comes in both a TruForm 1 and 2 gel gives some flexibility with respect to implant firmness and its activity on the breast. The gel fill of 95% is excellent from the point of view of prevention of rippling and achieving good shape.

Similarly, the availability of the 410 in a TruForm 2 or TruForm 3 gel enables the flexibility with respect to the amount of activity one wishes the implant to have on the breast. The 410 matrix is well thought-out and the dimensions tend to fit my patients very well.

Q: What is your preferred shape and texture?
A: I use mainly textured implants, largely because of their long-term stability of position. I use a mix of round and shaped implants, depending on the requirements of the individual patients.

Q: What has been the feedback from your patients, both short term and long term?
A: The feedback has been exceptional. The advantage we have with implants these days is that there is a variety of choices available and, by having a box of tools, one can use the appropriate tool for the appropriate job.

Q: Do you have any tips for your colleagues on how you use Natrelle implants?
A: I find the use of textured Allergan implants in a mainly subpectoral position in a well-fitting pocket with meticulous surgical technique gives very low risk of complications with excellent short-term and long-term predictability of result.

Capsular contracture rates are exceedingly low and this is no doubt a combination of the implant and the appropriate surgical technique. The key to this technique is really that of appropriate dimensional planning to select the appropriate implant, the use of an IMF incision, meticulous haemostasis with atraumatic sharp dissection and a hand-in-glove type pocket. Strong fixation of the neo IMF enables a predictability of result in that area.

Q: What’s your experience been like with Allergan, in terms of service and support?
A: Allergan have been kind enough to ask me to run the Allergan Training Academy for them in which, through a combination of lectures and live surgery, we run an education program for younger plastic surgeons on both primary augmentation and augmentation/mastopexy.

I think this support of ongoing education is the key to continued improvement of the results in the community with respect to the use of implants. I applaud Allergan for their commitment to education, which has been significant and ongoing with sponsorship of multiple educational opportunities for aesthetic practitioners both in the area of breast surgery and non-surgical procedures.

For more information contact Allergan on 02 9498 0100 or visit www.allergan.com.au
* Maxwell et al 2012. Natrelle style 410 form-stable silicone breast implants: core study results at 6 years. Aesthet Surg J. 32(6):709-17
** Hedén, P., et al. 2006. Prevalence of rupture in Inamed silicone breast implants. Plast. Reconstr. Surg. 118:303-8.

410 SHAPED GEL
Natrelle® 410 Highly Cohesive Anatomically Shaped Silicone- Filled Breast Implants

• Designed to deliver an anatomical shape
• Highly cohesive gel is designed to hold together and stay in place
• Designed for a natural feel
• May require a slightly larger
incision than round gel implants
• Indicated for patients 22 years or
older for breast augmentation
• Biocell® macrotextured surface
• Sizers also available

ROUND GEL

Natrelle® Silicone-Filled Breast Implants
• Cohesive gel that feels softer to the touch
• Styles include:
– Moderate
– Moderate-plus – High
– Extra-high
• Requires a larger incision than saline-filled implants
• Indicated for patients 22 years or older for
breast augmentation
• Smooth or Biocell® macrotextured surface
• Sizers also available

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