Cohesive Round or Cohesive Teardrop Breast Implants?

I am aiming to obtain full nice round breasts with fullness in the upper poles but not that extreme that they will look not natural. I also would like tough some fullness at the bottom so that the breast will hang a little bit.

My worries are that with teardrop Breast implants I will be completely flatten the upper poles after let say 6 years. On the other hand, with a round implant, I am scared that I will look fake. Would be great to know your opinion!

Doctor Answers 19

Round versus anatomical (tear-drop) shaped breast implants

You have asked an excellent question!

Most surgeons in the United States use smooth, round breast implants. Why?

First of all, it is important to realize the final shape of the augmented breast depends on several factors.

First, if you start with nice looking breasts, the chance of achieving nice looking augmented breasts are much higher.

The shape of the operated breast is very technique dependent. One can achieve bad results with either style implant if the implant pocket is too tight or too big, and the implant is too large or too small for that patient. Therefore, do not assume the tear-drop implant will automatically give you a better result.

There are three main disadvantage with the tear-drop implants. First, since the implant is flatter on top than the bottom, if the implant should rotate (and they usually do), then secondary surgery is needed to reposition the implant.

The implant company has made the surface of the tear-drop implant textured (rough to the touch), in order to minimize the chance of rotation. However, the downside of the rough surface is that the breast tissue will "stick" to the implant, which will increase the chance of rippling (wave-like motion under the breast skin).

The third disadvantage of the anatomical implants is the cost. These implants cost more due to manufacturing expenses. In my opinion, the theoretical advantages of the tear-drop implants are not worth the potential risks involved.

Santa Ana Plastic Surgeon
4.7 out of 5 stars 13 reviews

Cohesive round or teardrop implant

In Germany I believe you have the form stable, highly cohesive silicone implants. If this is true, either round or teardrop should be OK. They both maintain upper pole fullness. If you have the less cohesive silicone gel implants, the teardrop shape is better at maintaining upper pole fullness in my opinion. Round implants that are not high profile generally look very natural but do not maintain upper pole fullness as well as the teardrop. Ask your surgeon to hold up the implants like they would be in your body. A silicone gel implant's upper pole (the top) will "collapse"; once you see this you will see how it is hard to have excessive upper pole fullness. That being said, you can have excessive upper pole fullness with high profile or very large implants. When the surgeon holds up the teardrop implant, you will see that the upper pole maintains its shape. It should not change with time. Both round and tear drop types of implants can give a very natural result, if the correct size is selected for your frame. Also, in looking at your pictures you might have a mild form of tuberous breast. The distance from your areola to the fold looks a little short. Be sure to ask your plastic surgeon about this. Your fold may be need to be lowered. Given your anatomy, I think the teardrop would be nice for you, as it would help fill out the lower pole, where you are little deficient. Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

Cohesive Round or Cohesive Teardrop Breast Implants?

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. If I were seeing you in consultation I would probably recommend the use of smooth, round, silicone gel breast implants placed in the sub muscular ( "dual plane") position.

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.

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 know words such as “natural” or "C or D 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. You will find a separate page, on the same website, dedicated to breast augmentation surgery for petite patients. Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Round Cohesive Gel Implants Give a Natural Appearance

Hi patient in Germany,

I began my career 15 years ago convinced that an anatomical (teardrop) implant was the best choice to give patients a natural appearance. The more I used these implants the more I realized they offered no advantage over round implants and several disadvantages.

Disadvantages of shaped teardrop implants:

1. They can flip or spin leaving you with an asymmetry which sometimes requires surgery to repair

2. They are textured so they more easily show ripples and don't move and slide like a natural breast.

3. Because they are textured they are fixed to surrounding tissue (at least until they decide to spin or flip) making them for more easy to feel under the skin

4. The chance of needing revision surgery is higher because it is easier for the implants to heal in two slightly different positions on each side.

5. They cost more

If this has not convince you, then consider the fact that after 15 years of practice,I use almost all smooth round breast implants. They look just as natural especially in a sub-muscular position (under the pectoralis major muscle) and when appropriately sized for the patient (not way too large).

You do appear to have a slightly constricted(tight) lower pole (lower part of the breast below the nipple) so make sure your surgeon has experience with this type of breast augmentation. It can be a little more tricky especially since you want fullness in the bottom and for the breast to hang a little.

Don't worry about round implants looking fake. A round implant placed in the proper position with some radial scoring of your lower breast tissue (ask your surgeon about this) should give you an excellent result that looks natural.

One key point is because you are young and have a little tightness in the lower part of the breast it may take a few months for the implants to soften and drop into a good, more natural appearing position. So be a patient patient. Good Luck and I hope this helps.

David L. Mobley, MD, FACS
Sarasota Plastic Surgeon
4.6 out of 5 stars 16 reviews

Constricted Breasts

I think that the best result will be obtained by addressing your breast constriction. Notice how the lower half of each breast is tight; the breast mass appears to herniate out through the areola.

Whether you use a smooth, round implant (my choice) or a tear-drop-shaped implant is less important than a thorough release of your tissue itself.

Additionally, smaller implants (especially lower profile or moderate profile implants, rather than high profile) may give a more natural result because you don't have adequate skin excess to accommodate a large implant.

Michael C. Pickart, MD
Ventura Plastic Surgeon
5.0 out of 5 stars 5 reviews

Round vs teardrop

After a few months, it is difficult to tell which patients have round implants and which have teardrop, unless the teardrop turn and then breasts look kind of wide.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Teardrop versus round implants

Hi, I generally recommend round implants for cosmetic augmentation cases and teardrops for reconstruction.  If the implant is placed beneath the muscle, it should look fairly natural.  The implant will be able to fill both the upper and lower poles on you.  Good luck, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 13 reviews

Round seems to be the consensus of this panel

Since 9 of us here have leaned towards you using round shaped over tear drop shaped breast implants, I guess your question has been addressed.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Would I look better with round or anatomic (teardrop) breast implants?

Hi there-

While I have used anatomic implants in the past, I am not a big fan. The outcome is not as natural as it can be with a well done augmentation using round implants (contrary to what would seem to be the case), and there was even a well-done study that showed that in the body, the benefits of the implant being teardrop shaped are eliminated.

If that's not enough, in the course of normal daily life, there usually comes a time when the implant will flip.... If you have a round implant, guess what- it's still round... but if your implant is a teardrop shaped implant and it flips, well now you may have a strange bulge where it doesn't look good for you to have a bulge. Now you're running to the ladies room to try to massage the thing back into place while you frantically call your plastic surgeon for advice. On one occasion, I had to operate on a patient with anatomic implants because neither she nor I could get the thing to flip back into its normal position.

The only time I consider these is for post-mastectomy reconstruction.

In breast augmentation, round implants (assuming of course that good judgement and technique are used) will almost always give a better early and longer term outcome, with higher patient satisfaction and fewer problems. And they're even less expensive!

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Breast tissue release is more important than choice of breast implant.


1) The bottom of your breasts is very tight and constricted, and needs to be surgically opened up before implants are inserted. What you need is more complicated than just a breast augmentation.

2) After releasing the lower poles of your breasts, I would personally use round, smooth walled, cohesive silicone gel breast implants.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.