I like the natural look of teardrop implants but would round implants be more suitable w/ my lift? (Photos)

Hello,90% of American plastic surgeons have never used, nor intend to ever use shaped and textured implants. It’s an emotionally based decision that is unwarranted. The fact is that both older and newer data supports shaped and textured implants as having a lower risk of complications and re-operation than round smooth implants. So when you hear things like ‘shaped is for reconstruction and round is for cosmetic’ or ‘round works best’, you should know these responses are not factual. Go visit a few highly experienced ABPS certified/ASAPS member surgeons who have experience with both implants. They will corroborate what I’ve told you. 

I recommend smooth, round implants.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

There is no reason to choose an anatomic or tear drop shaped implant when considering a combination lift and implant procedure. In your shape of breast and chest, the implant needs to provide an expanded base for the breast with volume and a properly performed breast lift will shape the breast giving you the shape and contour you want.

I don't think you are going to find too many answers where an experienced surgeon is going to favor an anatomical or teardrop implant for a case such as yours.  The teardrop implants are an important part of breast reconstruction after cancer, but round implants are by far the best choice for nearly all cosmetic cases.As always, the best advice and the best implant can only come after you are seen, examined, and measured by an experienced surgeon.   

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Based on
your photographs, the best shape and contour could be achieved with an implant
and a breast lift.   A breast lift with an implant can result in a very nice shape if
good technique is used.   I prefer a round implant over a teardrop implant because a teardrop implant has a risk of malrotation with time.   The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Thanks for your question and the photos. I think you will do well with a combined lift and implant. I have really had good results with the newer more cohesive gels that are round (Mentor MPP Xtra). The biggest concern in my opinion is choosing an implant that fits the breast that is not too large. A big implant will weigh more and cause stress on the lift. This increases the risk of implant malposition and asymmetry as well as the need for revisions. We use the Vectra 3D imaging to provide patients a simulation of their expected outcome that shows the implant with the lift combined. An examination with measurements is necessary to give a more accurate recommendation. Best of Luck!

Dear candybrooke719,I use both tear drop (shaped) implants and round implants in my practice. One has to understand the dimensions of the breast to determine which implant would work best. A shaped implant looks like a tear drop and like a natural breast shape. This may sound like it makes the most sense for breast augmentation but if a patient has breast tissue already, this tends to push out or project the bottom part of the breast more so than what is natural. Two things that look like a breast don't necessarily make for a more natural looking breast. A round implant often times has a more natural look than a shaped implant because it increases the breast size more evenly. I still use shaped implants in a few circumstances when patients have no breast tissue. Patients that are very flat or have had a mastectomy. Shaped implants also have the increased risk, up to 30%, of rotation so I'm very careful when using or recommending them. The bottom line is that one should consult with a board certified plastic surgeon who does a lot of breast surgery to determine the best implant for each patient. All of my breast augmentations are designer breast augmentations which means that one size does not fit all. I customize the surgery and implant based on the characteristics of the patient and their goals.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question and photos.
There are several variables to be considered when answering this question. It is always difficult to make a diagnosis on photos alone, but you do appear to be a good candidate for a breast lift with smooth round implants. When you meet with a board certified plastic surgeon, they will perform a set of measurements that will help determine the type of lift needed. Another variable that needs to be discussed is what you are wanting. If you are wanting a fuller upper pole to your breast, then a round implant will be necessary.  If you are just wanting the breasts to be a little perkier and don't mind the size, then only a lift is necessary. I hope this is helpful

Thank you for the question and pictures. 
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.Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. 
Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. 
In my practice, "tailor tacking" is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY  closure of the skin (for example with temporary skin staples)  to double check the amount of skin that is to be excised during the procedure. This maneuver is done to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars.
 
Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural or larger breasts” 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 who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
Best wishes.

Hi Candybrooke719, For the most part, many surgeons who once used textured have switched back to the smooth surface implants for both saline and silicone. Shaped implants refer to a textured implant with a teardrop shape. They are sometimes referred to as “anatomical implants” however, the FDA made the manufactures stop referring to them as such, because it is a misleading title. These implants are not used as often because they lack upper pole fullness, which is a desirable effect when augmenting the breast! In my opinion it's counter intuitive to place a teardrop shaped implant, with it's volume focused on the lower pole, into a patient who needs a lift because all of their breast tissue is already in the lower pole. In my practice, patients are never expected to make determinations on things like implant shape, projection etc. Mostly because you can't. It's not a choice of either or. Just like the style of lift. If your case requires a full lift, there is no option to do a modified. You must choose the right procedure and implant for each specific case. It takes years of experience to know what procedure and implant is going to give an specific outcome. All my patients need to do is show me examples of what their ideal out come is from photos of other patient outcomes. From there, we discuss the options to make that happen. Patients come in a lot requesting shaped and high profile implants. They want the LOOK that they think these style implants will provide. But often, a round Moderate profile implant achieves this look. Every surgeon uses a different angle when working with patients to determine what size implants will give them the outcome they want. I have no idea what was the method your surgeon used or what took place, but THEY should be the one giving you answers to all of these questions! It is important to have a solid discussion with your surgeon beforehand about your wants and making sure their methods for helping you choose a size are satisfactory. It is a collaborative process. Good luck!