It was inevitable, when you think about it. Wrinkle fillers like JuvedermTM and Restylane® have become popular to the point where facial injection treatments are considered more or less routine these days. It makes sense, then, that the next step for manufacturers would be to create similar products for use elsewhere in the body.
That’s just what happened as MacrolaneTM, a new product from Q-Med AB, the Swedish company that produces Restylane, was launched last year. The company’s Web site touts the new filler as, “an innovative product indicated for breast enhancement, volume restoration and shaping of body surfaces.” Like Restylane, Macrolane is a viscous gel based on manufactured hyaluronic acid, a substance also found naturally within the body.
Macrolane is not yet approved for use in the U.S. and Canada, but it’s gaining popularity quickly in Europe. It’s not hard to imagine why: just as many women interested in facial rejuvenation choose fillers over traditional facelifts, many who would like bigger breasts stop short of committing to the knife but will consider what’s come to be known as a “boob jab.”
Breast augmentation via a thick needle? Is this the wave of the future? To date, reaction to Macrolane is all over the map.
Commenting on the probable drawbacks of Macrolane, a U.S. plastic surgeon, Dr. Steven Williams, pointed out a few reasons why the filler may be unlikely to give breast enhancement with implants a serious run for the money. One of the most obvious issues is the cost. First time treatment in Europe seems to run from about $3000 to about $6000, and according to Q-Med’s own Web site, “Macrolane is intended to last 9-12 months.” As the manufacturers term it, annual “top-up” is required.” Over a few years of use, a woman can easily spend several thousand dollars on Macrolane, outstripping the cost of surgical breast enhancement.
Another area of possible concern to some U.S. surgeons also relates to the amount of product needed to make breasts noticeably larger. Typically, 1 to 2 cc’s of hyaluronic acid-based wrinkle fillers are used for facial injections. For breast enlargement, at least 100 cc’s of product are required to make a difference, notes Dr. Williams. There seems to be uncertainty whether this kind of volume can stay natural looking, soft and smooth, resisting clumps and lumps inside the breast cavity. And there's concern about possible interference with mammography.
Of course, U.S. physicians do not have Macrolane available to them. An Irish plastic surgeon, Dr. Patrick Treacy, was much more positive about the product in a press release dated earlier this year. He noted that he had only seen two patients with Macrolane lumps that required removal and he described the gel as a “wonderful product.”
When you research the experiences of European women, there’s no clear thumbs up or thumbs down on Macrolane. Many patients are pleased with their results—happy they have gone up about a cup size without surgery. But some say their breasts are harder than they should be and look unnatural, even asymmetrical. Some women describe treatment as an easy experience, others say it’s invasive and causes more post-treatment pain than they expected.
In March of this year, Alice Hart Davis, an early “boob jab” patient, wrote about her experience in the (U.K.) Times Online. Davis said that while she was thrilled, at first, with larger breasts, after a few months one had shrunk to half its Macrolane-filled size and one had gone rock hard. After visiting her surgeon for a firm massage and a top-up, Davis was satisfied again until she later found a lump. After conducting more research with physicians and surgeons, the writer concluded her experiences were not unusual. One surgeon she spoke with, the head of plastic surgery at a London hospital, said he feels the need for caution about injecting materials into the breast due to the potential for changes down the road and possible interference with breast screening. This surgeon has so far declined to use Macrolane for breast augmentation.
Is Macrolane truly a viable alternative to surgical breast augmentation?
To date, product trials have been conducted only on relatively small samples of women and data on long-term effects is not yet available. Davis, the journalist, noted that this makes today’s Macrolane patients the guinea pigs.
In this case, “wait and see” is probably the right answer.