Instabreast: The 24 Hour Breast Augmentation

InstaBreast is a new and controversial temporary breast augmentation procedure. The procedure was described by New York plastic surgeon, Dr Noman Rowe. As an office procedure, it involves injection of saline solution into the breast tissues to increase volume. The fluid is slowly absorbed into the blood stream over the course of a few days and the volumizing effect is then reversed. Interesting names, such as the Cinderella breast augmentation or the lunch-time breast augmentation have been attributed to this procedure.

Why do it?

Why would a patient consider such a short-lived procedure? Well, Dr Rowe described this procedure as “an excellent way for women to see how their body might look before deciding on surgery”. It would appear that the primary indication (according to inventor of the procedure) is to “test drive” a breast augmentation, before committing to an implant size. Most plastic surgeons would consider this a rather extreme method of determining the optimal size. Most implant companies offer “sizing kits” for such purposes. An even better way of determining the potential effect of an implant is the use of a virtual reality augmentation, made possible by 3-D medical imaging systems, such as the Canfield VECTRA. Obviously other reasons, such as important social events, may also be considered by prospective patients.

Is it safe?

As with any new procedure, people may wonder if this is safe. The injected saline is obtained from sterile, pyrogen-free, intravenous solution bags. As long as sterile technique is maintained, the risks of infection are low. However, although saline is almost isotonic to tissue fluid in absolute numbers, the respective concentrations of sodium and chloride are quite different and this may have both local tissue and systemic effects.

What are the potential risks?

Saline is a relatively safe solution of sodium chloride (salt). As noted above, the chloride ion concentration is higher than either blood or tissue fluid. This has several physiological effects, such as a lower pH – to a rather acidic pH of 5.5 (normal arterial pH is 7.41) and infusion of a significant volume may cause a metabolic acidosis. In a healthy patient this effect may be negligible, but its effect in compromised patient should not be underestimated. Additional tissue effects, such as stretch and elastic recoil, as well as the tissue and vascular toxicity of high chloride ion solutions are of some concern.

Would you recommend this procedure?

Prospective patients should be aware that although it is offered on website of Dr Rowe, there are no scientific publications documenting the safety, efficacy and potential complications of the procedure. Presently, it would seem that the safety record is limited to the anecdotal experience of its inventor and it should be considered a highly experimental procedure at best. Most medical professionals would recommend avoiding such procedures until a reasonable body of good quality medical data is available. Patients who are considering a breast augmentation are advised to seek the opinion of a qualified plastic surgeon and consider a well-established technique until more research on this technique is done.

To the best knowledge of both the author and the Association of Plastic and Reconstructive Surgeons of Southern Africa (APRSSA), there are no plastic surgeons in South Africa who perform this procedure.