I detest the look of "dramatic" cleavage on the upper portion of the breast and would prefer a more natural slope with the nipple angled slightly upwards. I’m concerned about the complications of rotation and the textured implant having a less natural feel. I’m also worried if the teardrop shape is too mature for a 20 year old with breasts positioned higher on the chest wall. Are anatomical implants ideal for only mastectomy patients? Why aren't they more widely used?
Would Teardrop or Round Shaped Implants Be Ideal for Someone with Limited Breast Tissue Seeking Natural, Modest Results? (photo)
Doctor Answers 19
Your choices are limited - but nice results are still predictably achieved.
You are somewhat at a disadvantage because US surgeons have had limited choices of implants on which to base their opinions. Your best choice out of the implants that are available in the US for augmentation outside of a study setting, is likely a smooth round cohesive silicone gel implant from either Allergan or Mentor. To limit the excessive fullness to the upper chest and cleavage, choose a Plastic Surgeon is experienced and who can recommend an implant size and profile that will achieve your goals. A smaller sized implant placed into a partially sub-pectoral location should work nicely.
A little more background. Most US Plastic Surgeons have no experience with highly cohesive silicone implants -round or anatomical/teardrop shaped. For reconstructive surgery or for those surgeons participating in a clinical trial, they may have access to more highly cohesive gel implants with an anatomical shape. All round silicone gel implants currently available do have cohesive gel filler but the gel is softer than a gummy bear and therefore not comparable to those available in Canada, Europe and Asia. The most commonly used implants in the US: round, smooth cohesive silicone gel implants work well but have a revisional surgery rate of about 20% at 3 years. Various strategies are employed by experienced Plastic Surgeons to reduce their own rate of revision but these implants still have significant rupture, ripple and contracture rates that you should know about. In Canada, (not just in Europe) we have had access to anatomical shaped highly cohesive gel implants for more than 10 years and recently have access to highly cohsive gel round implants as well. In comparison to the implants that are currently available in the US, there is a lot of world literature to show lower revisional surgery rates. The rotatation risk with an anatomical shaped implant is real but is about 1% in experienced providers. Even with this unique risk, the re-operation rate has been shown to be lower than a smooth round and less cohesive gel implant like you have available. With all these choices available, no single type of implant the best for all patients.
Here is the good news for you: if you choose a smaller, smooth, round silicone gel implant placed into a sub-pectoral location - your risk of problems is lower than the published rates of 20% @ 3 years. Furthermore, with your lean physique your satisfaction will likely be higher than with a similar sized round, saline filled device.
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Round or teardrop shaped implants
The idea behind teardrop shaped implants was to try to mimic the natural appearance of a normal breast. They were quite popular during the 1990's and early 2000's. Some surgeons still like to use them for augmentation but I believe that most surgeons prefer round implants. The teardrop shaped implants sacrifice width for projection which tends to reduce general fullness unless a larger implant is used. There also can be a problem with rotation. I once had a teardrop shaped implant rotate 180 degrees. fortuantely, I was able to turn it back into normal position without surgery. It is far more important to choose an implant based on the dimensions of your breasts as they currenly are. Your photos would suggest to me that a teardrop shaped implant would not have the proper width to give you a natural appearance unless you went fairly large. Textured implants were designed to try to reduce the incidence of capsular contracture. I don't think they have been proven to do so and they are much more likely to cause rippling and are easier to feel. I defintely prefer smooth implants.
Round shape implants are my preferred implants
I have not used teardrop implants for over 10 years. The teardrop shape demands textured implants and the texturing is necessary to help “keep” the implants in position. Texturing does help decrease the incidence of capsular contracture, but at a cost; there is a greater tendency for rippling. Also, I have found that I have achieved less than optimal results with teardrop shaped implants and I have found little use for them over the past several years. Most women prefer either moderate plus or high profile implants. My feeling is that high profile implants give an outstanding result and are my preferred implants. I think that silicon high profile implants are the implants of choice for most women.
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Are teardrop implants better with limited breast tissue
You don't have much breast tissue, but what you have is nicely shaped. You would definitely need gel implants. The teardrop gel implants are textured so you would be more likely to feel the edge of the implant. I think you would get a natural, pleasing result with smooth walled gel implants placed submuscularly.
Teardrop vs. round breast implants and natural results
Teardrop shaped implants in normal cosmetic breast augmentation have been abandoned for a whole host of short term and long term reasons. Properly fitted smooth-wall, round implants (properly filled saline or gel-filled) give the best short term and long term results for normal breasts such as yours. Be sure the implant is properly matched to the width of your breast and is no more than the middle profile projection as well as placed sub-pectorally and you will not have to worry about "dramatic" cleavage or upper breast contour problems. You will have to accept that your right breast and nipple are higher than the left and the level of your inframammary crease will have to be lowered a bit (and controlled) to fit the round implant properly.
Tear-Drop implants are NOT superior to Round implants
After implants are placed retro-pectorally, pressure generated by the pectoral major muscle distorts the shape. Implants that look tear-drop when sitting on a tabletop will NOT assume the same position when compressed by the pectoral major muscle. Often tear-drop shaped implants can rotate or be mal-positioned, which is not desirable. I have never used tear-shaped implants for these reasons, not even in mastectomy patients. They are not more widely used because they have no advantage. Looking at your pictures, you would probably benefit from a silicone gel, retro-pectoral implants with a moderate size so they will look natural and not overly enlarge.
Best of luck,
Gary M. Horndeski, M.D.
Round breast implants are more natural for most patients
One very important thing to know about implant slection is that because the gel in round implants is softer than the gel in shaped implants, the round implants have a teardrop profile when you are upright. Another advantage of the softer gel is that they will feel more like natural breasts. If the base shape of the breasts is round (as it appears to be in your photos) the round implants are the best fit.
Would Teardrop or Round Shaped Implants Be Ideal for Someone with Limited Breast Tissue Seeking Natural, Modest Results?
Besides not being available, tear drop implants were a great idea but really did not create the breasts that they were supposed to. I used many of them in the early 90's and changed back to round and the main reason is that there is no problem with rotation and xray studies showed that most round implants actually formed a teardrop shape when standing. But this all may change when 410's come on the market here in the US!
i was one who used the teardrop implants. i switched. i feel the moderate plus gel implant will give you the natural look which you are requesting. i think the moderate plus will give you a better result than the high profile as you have quite a wide distance between your breast and a wider implant will help this. good luck