EVERY
WOMAN HAS THE
TO CHOOSE HER PATH FORWARD
Actual breast reconstruction patient with Natrelle INSPIRA® Breast Implants.
Individual results may vary.
Supporting
women and their breast
cancer journeys
If you’ve decided to have reconstruction with breast implants, Natrelle® has a wide range of innovative offerings designed to meet your expectations.
LISA
Reconstruction after breast cancer is a journey. It helped me discover my new normal. It was my choice and
IT’S EXACTLY WHAT I WANTED.”
Actual breast cancer and breast
reconstruction patient with
Natrelle INSPIRA® Breast Implants.
Individual results may vary.
KAYLA
After testing positive for BRCA2, I decided to have a double mastectomy and reconstruction with implants. Breast reconstruction helped me
MOVE FORWARD.”
Actual breast reconstruction patient with
Natrelle INSPIRA® Breast Implants.
Individual results may vary.
Breast reconstruction basics
When you have a mastectomy, you lose breast tissue, some skin, and possibly your nipple and areola. Breast reconstruction results have improved over the years. While your plastic surgeon can’t give you the same breast you had prior to your mastectomy, he or she may be able to give you a reasonable likeness of your premastectomy breast.
Immediate or delayed reconstructive surgery
Will you begin your reconstruction surgery immediately—at the time of your mastectomy—or will you delay your reconstruction surgery until after you have healed?
Advantages
Disadvantages
Advantages
Immediate reconstruction
Eliminates an operation since it’s performed at the same time as the mastectomy.
Delayed reconstruction
Provides time to treat and evaluate the cancer. Some women may need radiation after mastectomy, which can cause problems like delayed healing and scarring.

Provides time to quit smoking and/or lose or gain weight. Smoking, being overweight or too thin can cause problems with your reconstruction.
Disadvantages
Immediate reconstruction
Requires a longer surgery.
Delayed reconstruction
Requires an additional operation.

Creates a time where you will have the appearance of no breast(s).
I’M
TRUSTING MY
journey
Actual breast cancer and breast reconstruction patient with Natrelle INSPIRA® Breast Implants.
Individual results may vary.
I’M
TRUSTING MY
journey
Implant-based breast reconstruction
This type of reconstruction shapes the breast with implants and is usually performed in 2 stages: Using a tissue expander in the first stage and then inserting a breast implant under the muscle in the second stage.

An innovative advancement allows for placement of a tissue expander or silicone breast implant over the chest muscle (prepectorally). Learn more about prepectoral reconstruction below, and talk to your surgeon to determine whether this approach is an option for you.
Advantages of Implant-based Reconstruction
The procedure is performed in areas where you are already having surgery; no new incisions are usually required.
Disadvantages of Implant-based Reconstruction
Implants are not lifetime devices and you may require additional surgery in the future.
i am
what i choose
Actual breast cancer and breast reconstruction patient with Natrelle INSPIRA® Breast Implants.
Individual results may vary.
Over the muscle (pre-pec) technique
This technique allows for placement of a tissue expander or silicone-filled breast implant over the chest muscle (prepectorally).
Advantages of Pre-pec Technique
Because the chest muscle isn’t cut:
  • Potentially shorter recovery time
  • Potentially less pain or side effects caused by cutting the chest muscle
Because the implant is placed over the muscle:
  • Surgeon has greater control of shape and form of the breast
  • Flexing your chest muscle may/should not make the breast implants move in unpleasant, unnatural ways
Disadvantages of Pre-pec Technique
  • Not all patients are candidates for pre-pec placement because it requires enough tissue in good condition after a mastectomy
  • Risk of visible rippling of the implant
  • Not all surgeons have experience with this newer technique
Subpectoral (under the muscle) technique
This technique involves placing a breast implant under the chest muscle. In some cases, this can be done immediately after the mastectomy.

If you have minimal breast tissue, your surgeon may recommend placing a tissue expander under your skin and chest muscle before placing the implant. A tissue expander is like a balloon, which can be inflated to stretch the skin and muscle over several months, making room for your implant.
Advantages of Sub-pec Technique
  • Many surgeons have experience with this well-known technique
  • May minimize risk of visible rippling of the implant
Disadvantages of Sub-pec Technique
Because the chest muscle is cut:
  • Potentially longer recovery time
  • Potentially more pain or side effects caused by cutting the chest muscle
Because the implant is placed under the muscle:
  • Flexing your chest muscle may make the breast implants move in unpleasant, unnatural ways
Two-stage vs one-stage breast reconstruction
Two-stage breast reconstruction is the most common type of breast reconstruction performed. The first stage involves placing a tissue expander to recreate a breast pocket after the breast tissue has been removed. In the second stage, the implant is placed into the breast pocket.

One-stage, or direct-to-implant (DTI), breast reconstruction involves placing the implant immediately after breast tissue has been removed.
Advantages of
DTI Reconstruction
The breast implant can be placed immediately instead of requiring an additional tissue expander step.
Disadvantages of
DTI Reconstruction
Not every patient is a candidate.
First stage
This procedure first uses a tissue expander, which is surgically inserted and slowly expanded over time to create a space for the implant. Typically, you will meet with your plastic surgeon every other week to fill the expander with sterile saline in order to gradually stretch the skin.
The tissue expander with over 30 years of clinical experience
Natrelle® 133S Smooth Tissue Expanders are made to match Natrelle INSPIRA® Round Gel Breast Implants. This means that the tissue expander creates a space customized for the breast implant.
Second stage
Once the space reaches the correct size and the tissue has healed, a second surgery will remove the tissue expander and replace it with the breast implant. If a mastectomy was only performed on one breast, some patients choose to have the other breast augmented to maintain symmetry.
The #1 surgeon-selected gummy breast implant collection in the US*
Natrelle INSPIRA® Round Gel Breast Implants are designed to give you the look and feel that’s important to you.
*Based on surgeon survey data, July 2019 (N = 80).
Your choice. Your look.
before
After
before
After
Primary reconstruction with
Natrelle INSPIRA® Cohesive Style SCF-560
Photos provided by Dr Mark L. Venturi. Individual results may vary.
See more results
ALLERGAN,
the maker of Natrelle®, has been at the forefront of breast reconstruction advancements.
learn more
Natrelle® Breast Implants Important Information
SEE MORE +
Natrelle® Breast Implants Important Information
Who may get breast implants?
Natrelle® Breast Implants are approved for women for the following:
IMPORTANT SAFETY INFORMATION
Who should NOT get breast implants?
What should I know before getting breast implants?
What should I tell my doctor?
Tell your doctor if you have any of the following conditions, as the risks of breast implant surgery may be higher:
What are some complications with breast implants?
Key complications are reoperation, implant removal with or without replacement, implant rupture with silicone-filled implants, implant deflation with saline-filled implants, and severe capsular contracture (severe scar tissue around the implant). Other complications include asymmetry, nipple/breast/skin sensation changes, scarring, or wrinkling/rippling. Talk to your doctor about other complications.
Talk to your doctor. For more information see the patient brochures at www.allergan.com/products. To report a problem with Natrelle® Breast Implants, please call Allergan at 1-800-433-8871.
Natrelle® Breast Implants are available by prescription only.
Natrelle® 133S Smooth Tissue Expanders Important Information
Approved Uses
Natrelle® 133S Smooth Tissue Expanders are approved for breast reconstruction following mastectomy, treatment of underdeveloped breasts, and treatment of soft tissue deformities.
IMPORTANT SAFETY INFORMATION
Who should NOT get tissue expanders?
Do not use if you:
What else should I consider?
What are possible complications?
Deflation, tissue damage and/or appearance of the implant through the skin, infection, unwanted shape, unintended blood or fluid collection, capsular contracture (tightening of scar tissue that causes the breast to harden), premature device removal, bone/pain/sensation changes, and inflammation.
For more information, please visit www.allergan.com/products. To report a problem with Natrelle®, please call Allergan at 1-800-433-8871.
Natrelle® 133S Smooth Tissue Expanders are available by prescription only.
BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:
  • Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity
  • Moderate to severe lateral canthal lines associated with orbicularis oculi activity
  • Moderate to severe forehead lines associated with frontalis activity
IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING
WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and spasticity and at lower doses.

CONTRAINDICATIONS
BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.
WARNINGS AND PRECAUTIONS

Lack of Interchangeability Between Botulinum Toxin Products The potency units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect

Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System

There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects With Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions).

Dysphagia and Breathing Difficulties

Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning).

Pre-existing Conditions at the Injection Site

Caution should be used when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s).

Dry Eye in Patients Treated With BOTOX® Cosmetic

There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).

The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).

DRUG INTERACTIONS

Co-administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.

The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.>

Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.

USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.

Please see BOTOX® Cosmetic full Product Information including Boxed Warning and Medication Guide.
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Natrelle® Breast Implants Important Information
SEE MORE +
Natrelle® Breast Implants Important Information
Who may get breast implants?
Natrelle® Breast Implants are approved for women for the following:
IMPORTANT SAFETY INFORMATION
Who should NOT get breast implants?
What should I know before getting breast implants?
What should I tell my doctor?
Tell your doctor if you have any of the following conditions, as the risks of breast implant surgery may be higher:
What are some complications with breast implants?
Key complications are reoperation, implant removal with or without replacement, implant rupture with silicone-filled implants, implant deflation with saline-filled implants, and severe capsular contracture (severe scar tissue around the implant). Other complications include asymmetry, nipple/breast/skin sensation changes, scarring, or wrinkling/rippling. Talk to your doctor about other complications.
Talk to your doctor. For more information see the patient brochures at www.allergan.com/products. To report a problem with Natrelle® Breast Implants, please call Allergan at 1-800-433-8871.
Natrelle® Breast Implants are available by prescription only.
Natrelle® 133S Smooth Tissue Expanders Important Information
Approved Uses
Natrelle® 133S Smooth Tissue Expanders are approved for breast reconstruction following mastectomy, treatment of underdeveloped breasts, and treatment of soft tissue deformities.
IMPORTANT SAFETY INFORMATION
Who should NOT get tissue expanders?
Do not use if you:
What else should I consider?
What are possible complications?
Deflation, tissue damage and/or appearance of the implant through the skin, infection, unwanted shape, unintended blood or fluid collection, capsular contracture (tightening of scar tissue that causes the breast to harden), premature device removal, bone/pain/sensation changes, and inflammation.
For more information, please visit www.allergan.com/products. To report a problem with Natrelle®, please call Allergan at 1-800-433-8871.
Natrelle® 133S Smooth Tissue Expanders are available by prescription only.
BOTOX® Cosmetic (onabotulinumtoxinA) Important Information

Indications

BOTOX® Cosmetic (onabotulinumtoxinA) is indicated in adult patients for the temporary improvement in the appearance of:
  • Moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity
  • Moderate to severe lateral canthal lines associated with orbicularis oculi activity
  • Moderate to severe forehead lines associated with frontalis activity
IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING
WARNING: DISTANT SPREAD OF TOXIN EFFECT

Postmarketing reports indicate that the effects of BOTOX® Cosmetic and all botulinum toxin products may spread from the area of injection to produce symptoms consistent with botulinum toxin effects. These may include asthenia, generalized muscle weakness, diplopia, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening and there have been reports of death. The risk of symptoms is probably greatest in children treated for spasticity, but symptoms can also occur in adults treated for spasticity and other conditions, particularly in those patients who have an underlying condition that would predispose them to these symptoms. In unapproved uses and approved indications, cases of spread of effect have been reported at doses comparable to those used to treat cervical dystonia and spasticity and at lower doses.

CONTRAINDICATIONS
BOTOX® Cosmetic is contraindicated in the presence of infection at the proposed injection site(s) and in individuals with known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation.
WARNINGS AND PRECAUTIONS

Lack of Interchangeability Between Botulinum Toxin Products The potency units of BOTOX® Cosmetic are specific to the preparation and assay method utilized. They are not interchangeable with other preparations of botulinum toxin products and, therefore, units of biological activity of BOTOX® Cosmetic cannot be compared to nor converted into units of any other botulinum toxin products assessed with any other specific assay method.

Spread of Toxin Effect

Please refer to Boxed Warning for Distant Spread of Toxin Effect.

No definitive serious adverse event reports of distant spread of toxin effect associated with dermatologic use of BOTOX® Cosmetic at the labeled dose of 20 Units (for glabellar lines), 24 Units (for lateral canthal lines), 40 Units (for forehead lines with glabellar lines), 44 Units (for simultaneous treatment of lateral canthal lines and glabellar lines), and 64 Units (for simultaneous treatment of lateral canthal lines, glabellar lines, and forehead lines) have been reported. Patients or caregivers should be advised to seek immediate medical care if swallowing, speech, or respiratory disorders occur.

Serious Adverse Reactions With Unapproved Use

Serious adverse reactions, including excessive weakness, dysphagia, and aspiration pneumonia, with some adverse reactions associated with fatal outcomes, have been reported in patients who received BOTOX® injections for unapproved uses. In these cases, the adverse reactions were not necessarily related to distant spread of toxin, but may have resulted from the administration of BOTOX® to the site of injection and/or adjacent structures. In several of the cases, patients had pre-existing dysphagia or other significant disabilities. There is insufficient information to identify factors associated with an increased risk for adverse reactions associated with the unapproved uses of BOTOX®. The safety and effectiveness of BOTOX® for unapproved uses have not been established.

Hypersensitivity Reactions

Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.

Cardiovascular System

There have been reports following administration of BOTOX® of adverse events involving the cardiovascular system, including arrhythmia and myocardial infarction, some with fatal outcomes. Some of these patients had risk factors including pre-existing cardiovascular disease. Use caution when administering to patients with pre-existing cardiovascular disease.

Increased Risk of Clinically Significant Effects With Pre-existing Neuromuscular Disorders

Individuals with peripheral motor neuropathic diseases, amyotrophic lateral sclerosis, or neuromuscular junction disorders (eg, myasthenia gravis or Lambert-Eaton syndrome) should be monitored when given botulinum toxin. Patients with neuromuscular disorders may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia, and respiratory compromise from onabotulinumtoxinA (see Warnings and Precautions).

Dysphagia and Breathing Difficulties

Treatment with BOTOX® and other botulinum toxin products can result in swallowing or breathing difficulties. Patients with pre-existing swallowing or breathing difficulties may be more susceptible to these complications. In most cases, this is a consequence of weakening of muscles in the area of injection that are involved in breathing or oropharyngeal muscles that control swallowing or breathing (see Boxed Warning).

Pre-existing Conditions at the Injection Site

Caution should be used when BOTOX® Cosmetic treatment is used in the presence of inflammation at the proposed injection site(s) or when excessive weakness or atrophy is present in the target muscle(s).

Dry Eye in Patients Treated With BOTOX® Cosmetic

There have been reports of dry eye associated with BOTOX® Cosmetic injection in or near the orbicularis oculi muscle. If symptoms of dry eye (eg, eye irritation, photophobia, or visual changes) persist, consider referring patients to an ophthalmologist.

Human Albumin and Transmission of Viral Diseases

This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.

ADVERSE REACTIONS

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for glabellar lines were eyelid ptosis (3%), facial pain (1%), facial paresis (1%), and muscular weakness (1%).

The most frequently reported adverse reaction following injection of BOTOX® Cosmetic for lateral canthal lines was eyelid edema (1%).

The most frequently reported adverse reactions following injection of BOTOX® Cosmetic for forehead lines with glabellar lines were headache (9%), brow ptosis (2%), and eyelid ptosis (2%).

DRUG INTERACTIONS

Co-administration of BOTOX® Cosmetic and aminoglycosides or other agents interfering with neuromuscular transmission (eg, curare-like compounds) should only be performed with caution as the effect of the toxin may be potentiated. Use of anticholinergic drugs after administration of BOTOX® Cosmetic may potentiate systemic anticholinergic effects.

The effect of administering different botulinum neurotoxin products at the same time or within several months of each other is unknown. Excessive neuromuscular weakness may be exacerbated by administration of another botulinum toxin prior to the resolution of the effects of a previously administered botulinum toxin.>

Excessive weakness may also be exaggerated by administration of a muscle relaxant before or after administration of BOTOX® Cosmetic.

USE IN SPECIFIC POPULATIONS

There are no studies or adequate data from postmarketing surveillance on the developmental risk associated with use of BOTOX® Cosmetic in pregnant women. There are no data on the presence of BOTOX® Cosmetic in human or animal milk, the effects on the breastfed child, or the effects on milk production.

Please see BOTOX® Cosmetic full Product Information including Boxed Warning and Medication Guide.
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