"Implants are designed for a specific, narrow range of filling volumes," said Friedman. "If implant volume is reduced to below the manufacturer's recommended volume, the risk of deflation increases. If implant volume is significantly increased, the implant will become unnaturally firm."
In addition to limited adjustable volume, the extra port attached to these implants can become a potential source of discomfort and complications.
"There might be a problem of disengaging the tube from the implant because of the scar tissue that may form in that area," said Antell.
"Few of my patients would be accepting of a filling port placed just beneath the skin," Friedman said. "These ports are quite hard -- think metal and rubber -- and are sometimes uncomfortable."
"The exact risk of infection is unknown but is increased if a port is used," said Dr. Brent Moelleken, clinical assistant professor at UCLA. "How would a woman feel if she developed an infection in her breast implants and had to have them removed just because she wanted to be 30cc larger?"
But the draw of adjustable implants seems to appeal to certain patients.
"If the [adjustable implants] are offered to a patient and the advantages are explained, out of the last 102 patients last year, 100 of them have opted for having adjustable breast implants," Jeneby said. "Patients absolutely love them. I don't know a single person who has had a negative comment."
"The procedure is very safe in my opinion," said Watts.
But if adjustable breast implants are such a great idea, why aren't they widely used even though they have been available for a while?
"Surgeons are used to doing regular implants, and they haven't learned how to use adjustable breast implants yet," said Jeneby.
While surgical inexperience with adjustable breast implants may be part of the reason for their limited use, many surgeons worry about added risks associated with these implants.
With adjustable breast implants, "the increased risk of implant deflation due to valve failure, and dysfunction of the filling port must be considered," said Friedman.
"Ideally, the size of implants should be determined in advance of the surgery, based on the woman's dimensions and size requirements," said Moelleken. "The best results are obtained from an implant that is filled to the optimal amount, not underfilled or overfilled. Why not put the right size to begin with?"
Regardless of what kind of implants a patient chooses, though, open communication between doctor and patient is crucial.
"There is no substitute for a candid discussion about desired breast implant size prior to surgery. Your first shot is your best shot," said Friedman.