Understanding Implants: Medical, Cosmetic, Enhancement, Replacement, and What Goes into Customizing Them

By Dr. James Elist, Inventor – The Himplant® (Successor to the Penuma® Aesthetic Penile Implant)

Implants have witnessed exciting advancements in recent years, leading to increasingly better patient outcomes. Researchers have not only improved the devices themselves, but also surgical techniques, making procedures as streamlined as possible and reducing the appearance of any scars.

Here, I explain how different kinds of implants have evolved, as well as the procedures that go into customizing them best for individuals.

Implants for the heart and cardiovascular system

Over the years, pacemakers have become smaller even while regulating the heart more effectively. More recently, research has sought to decrease the amount of hardware needed even while improving heart function.

For instance, leadless pacemakers are so small that they can fit entirely within the heart. They can also function independently, which eliminates leads to units outside the heart. Pacing the heartbeat has also improved, since researchers are learning how to capture and send signals to a central part of the heart’s electrical system called the bundle of His.

For patients who need their blood pressure constantly monitored, another implant can be placed in an artery that measures it 30 times every second and sends the data to both the patient and their medical team. There’s even an implant that has been shown to reduce patients’ blood pressure called MobiusHD, a device that counteracts hypertension by tricking the brain into reducing the heart rate and widening blood vessels.

Implants for the brain

Implants can even modulate the amount of cerebrospinal fluid (CSF) in the brain. These shunt systems reduce pools of CSF that accumulate in the brain and channel them to another part of the body, such as the abdomen. 

In one recent development, researchers at the University of Connecticut and the Yale University School of Medicine have created a noninvasive device that measures the flow of shunted CSF in real time. This ingenious technology uses infrared light and a hair sensor not only to track the rate of CSF flow, but also to raise the alarm if the shunt stops working.

Implants for the senses

Cochlear implants, neural implant technologies that can restore hearing, rely on arrays of electrodes in the inner ear. Recent research has led to new findings about where to place these electrodes and how apart they should be, as well as improved the design and materials of the sensors themselves.

Phakic intraocular lenses — also known as phakic lenses for short — are plastic or silicone implants that correct the patient’s vision. Since the eye’s own lens is left in place, these are different from intraocular lenses, which replace faulty lenses due to cataracts.

Interestingly, researchers have identified potential improvements to these implants for the eyes, such as modifying their surfaces and adding a layer of polymers, that have yet to be brought to market.

Implants for hips and knees

Today’s hip replacements are made from highly cross-linked polyethylene, which is a durable plastic. It can last up to 25 years, which is up to 15 years longer than those made from other materials.

Similarly, knee replacements are now made of cobalt chrome, which has improved patients’ mobility as well as improved the device’s longevity. Meanwhile, surgeries that used to require patients to spend a week in the hospital have been perfected to the degree that patients can go home the same day.

Dental implants

Dental implants have also come a long way, as computer-aided design (CAD) and 3D printing have made the fabrication process much quicker and promise a better way to customize abutments for individual patients. Meanwhile, companies are working on magnetic systems for attaching dentures and holding them more firmly in place.

In some cases, patients can even get a crown the same day that their tooth is removed. As a result, they heal quicker, too. This technique is referred to as “immediate loading.”

Breast implants

Over the years, silicone breast implants have given way to saline gel, which the body can readily reabsorb in the case of leaks. In addition, surgeons have found ways to not only place the implants both above and underneath the muscle, but have also discovered that smooth implants avoid irritating the surrounding tissue, unlike textured implants.

One of the most exciting advances in this field, however, has actually done away with implants. In Autologous Breast Augmentation, the surgeon either reconfigures the breast tissue to create lift or removes fat from another location, such as the thighs or belly, and adds it to the breast.

Male enhancement implants

Breast implants were actually my initial inspiration for developing effective implants for male enhancement. Past enhancement technologies like pumps and injections have proven ineffective. Silicone penile implants can actually deliver real returns. In fact, the FDA has cleared such devices for these purposes. 

The latest generation male enhancement implants are made of medical-grade silicone that can increase patients’ girth and flaccid length by one to two inches on average. Procedures typically do not leave a visible scar, since the incision is small and is designed to blend into the natural appearance of the scrotum.

Customizing implants

As the science of implants advances, patients increasingly experience positive results that support and improve their quality of life. Regardless of the kind of implant, however, close supervision from qualified medical professionals is indispensable. 

Each and every implant must be designed and placed with an eye to that specific individual’s situation and needs. In each case, precise measurements must be taken and strategies developed to achieve the desired results. With dental implants, for instance, molds of the mouth allow for perfectly fitting prosthetics to be created. While standard implants can fit some patient’s needs, in most cases, customized implants deliver the best results.

Due to the tireless efforts of researchers, the future of implants promises to bring further refinements and improvements to patients around the world. As a result, new innovations we can’t even imagine today will emerge to sustain and enhance our lives.

Dr. James J. Elist, creator of the Himplant®, the successor to the Penuma® aesthetic penile implant, has been in private practice in Beverly Hills, California since 1982. He specializes in impotency, male sexual dysfunction, and enlargement procedures and is highly regarded as one of the top urologists in the country. Himplant® is the first FDA-cleared penile implant for male cosmetic enhancement and has been successfully implanted in thousands of men since 2004. The procedure has been featured in various major publications, and it was studied in an IRB-approved five-year clinical study of over 400 Penuma® patients published in the peer-reviewed Journal of Sexual Medicine.