Do Tear Drop Implants Rotate?

Question

I'm a petite A cup, I'm trying to get fat transfer first to get more breast tissue and a better basis for implants. tear drop shaped implants or round implants? WANT: natural look, preferably large B or a small C cup. scared of wrinkling/rippling of the implants, it says that non textured, under the muscle silicon implants are the ones to prevent rippling. tear drop shaped implant will rotate if its not textured? does that mea it will wrinkle? do all tear drop implants rotate?

Scott C. Sattler, MD, FACS · Answer

I would disagree with one of the previous commenters- fat grafting to the breast has entered the mainstream and it is a safe and reasonable way to add volume to the breast. As for teardrop shaped 'form stable' implants, I think there a few unique anatomic indications to use these shaped devices (constricted breasts, for example) - and they certainly appear to have a lower capsular contracture rate than our current round silicone implants (in the USA)...but the implant rotation is a problem- precise implant pocket dissection is essential to keep these devices from spinning around and changing the shape of the breast.

Michael Constantin Gartner, DO · Answer

All teardrop implants are textured to reduce the risk of rotation, which does exist. However, this risk is very small.

John L. Burns Jr., MD · Answer

Teardrop or anatomic implants have a textured coating to promote adherance to the breast tissue thereby preventing rotation or movement of the implant. However, even with the textured coat, they can rotate which can result in a distorted appearance of the breast, especially in thin women with limited soft tissue coverage.

Andrew P. Trussler, MD · Answer

Anatomic breast implants or tear drop shaped implants must be textured to facilitate adherence to prevent rotation when placed in the breast pocket. The textured shell can be thicker and form more visible rippling. These factors introduce negative variables into a procedure which should have a very reliable outcome. A conservative smooth, round implant placed under the muscle can produce a very natural look which can be delivered with a high degree of predictability. I hope this helps. Dr. Trussler

Richard Greco, MD · Answer

I do not use tear drop implants because when they are placed under the pectoralis muscle - they look the same as round implants, unless they rotate - then they look very awkward.  Little benefit, big risks.

	Silicone implants are a good choice in most patients with small amount of breast tissue to cover the implants.  You can get a very natural result.

Gregory Turowski, MD, PhD, FACS · Answer

Tear drop implants can rotate and become distorted even though they are textured.  I have found that the round implants tend to provide the greatest amount of lift, fullness, and cleavage and due to the round shape, it does not pose the risk of implant rotation. I do not like tear drop implants

Otto Joseph Placik, MD · Answer

Anatomic implants may sound sexy but they are textured (and more likely to be palpable); they have also rotated resulting in an abnormal look. I generally avoid these but use them for breast reconstruction.

Christopher V. Pelletiere, MD · Answer

First off, all anatomical ( tear-drop) shaped implants are textured. They are designed with the texturing to insure that they do not rotate at all. If they do, then the volume will shift and distort the shape of the breast. Fat trasfers to the breast are very controversial and you should proceed with caution. Any little bit of fat necrosis ( not all of the fat will live once replanted) will calcify and can mimic breast cancer. This makes mammograms and a diagnosis harder. This is why in the US it is still looked upon with scepticism and caution. Going under the muscle would be very advisable, but if you are extremely thin, then the chances of some rippling with any type of implant are higher, regardless of the placement and the size. I hope this helps.

Tom J. Pousti, MD · Answer

Thank you for the question. These days there are a variety of breast implants available; the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally, I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “very natural” or "B or C cup" etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Michael Law, MD · Answer

Rotation of shaped implants was a common problem many years ago, as were other issues that led to them being taken off the market. It is not a problem associated with the current generation of shaped, form-stable, highly cohesive silicone gel breast implants. One U.S. implant company has recently reported a rotation rate of zero in a clinical study of almost 1800 patients with shaped breast implants. The newest shaped or ‘anatomic’ breast implants are completely different medical devices than those that were available twenty years ago. Previous generations of shaped implants were both silicone gel and saline implants, and none of them performed well over the long term. The older shaped gel implants contained liquid silicone gel, and the shells had a high rate of failure and gel ‘bleed’ (i.e. some of the liquid silicone gel could ooze through tiny pores in the outer shell and escape the implant, without a tear or hole in the implant shell). The shaped saline implants felt firm and unnatural, had a tendency to rotate and also had a high failure rate. Breast implant technology has advanced considerably since the days of the first ‘anatomic’ implants, and the new generation of shaped silicone gel implants has many advantages over the older versions:1.The new ones are highly cohesive, meaning the gel is in a semi-solid state. Cut one of these implants in half and you’re holding half of a solid implant.2.The shells are much more durable, producing lower implant failure rates.3.A wide variety of shapes and sizes are available, meaning a ‘custom fit’ can be found for each patient.4.The rates of capsular contracture are much lower (the reported rate varies by manufacturer). The new generation of shaped, form-stable implants (available in the U.S. for less than two years now) are an ideal choice for particular patients. One type of patient that is well-served by these implants is the fit, athletic, A to small B patient who has very little lower pole tissue, needs to have the inframammary fold lowered, and who wants to transition up 1 or 2 cup sizes. This is one of the most challenging augmentation scenarios, as there is little natural tissue to conceal the implants. I get results with shaped, form stable implants in these patients that were previously not achievable with round devices. I have been placing shaped, form-stable breast implants for a year and a half and I have seen no cases of rotation / malposition, no cases of visible folds / ripples, and no cases of capsular contracture. Rotation of these implants should not occur if pocket dissection is meticulous. Not every patient needs a shaped implant – plenty of patients do just fine with a pair of round implants. But for specific indications, in my opinion, there is not a better implant choice. Especially if the goal is a natural-appearing breast augmentation result.

Do Tear Drop Implants Rotate?

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