Breast Augmentation textured teardrop "gummy bear" implants?

(I'm going with a 500cc implant) Pros and cons of the textured form stable tear drop implant? Above or below the muscle?

Doctor Answers 14

Shaped Silicone Implant vs. Round Implant

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Thank you for posting your question.

Implant selection is one of the most critical aspects in order to achieve a good outcome during a breast augmentation.

Breast measurements will guide the surgeon to choose an implant that your breast can tolerate well. I rarely perform a breast augmentation with implants greater than 400cc since I feel not that many patients have the tissue quality to support that weight for a long period of time. Therefore, when you mentioned you are considering a 500cc implant, this by itself could prevent you from having a great, long lasting result if your breast tissue quality is not appropriate. 

All shaped implants are highly cohesive (form-stable, "gummy bear") and textured. Patients with thin breast tissue and a thin lower pole skin thickness will benefit from form-stable implants as they will show less ripples. The only company that has form stable, "gummy bear" implants that are round as of today is Sientra. Unfortunately, they are not available for implantation as of now. Another good option is the new "over-filled" implants from Allergan - INSPIRA. The silicone in this implant is the same as the regular silicone implants, but they are "over-filled". Therefore, the risk of showing ripples in thin patients is also lower.

When it comes to shaped implants, the main concern for patients and surgeons is the remote possibility of malrotation. There is a concern that the breast will look distorted when a shaped implant rotates. The most important thing you can do is find a surgeon with experience using shaped implants as the surgical technique is the most important factor to prevent malrotation. The pocket for your implant in this case needs to be created exactly to fit the implant. When using a round implant the pocket does not have to be as exact.

Texture in an implant has been showed in some reports to decrease the rate of encapsulation of your implant.
It will also allow the implant to remain in position which will decrease the chances of malrotation and also of implant displacement to the axilla when laying down at the beach for example.

Submuscular placement or above the muscle?
The most common location for an implant is under the muscle.
Bodybuilders usually get their implants above the muscle because otherwise their muscles will constantly push on the implant,which can cause bottoming out.
An implant placed over the muscle will create more lift, and may even fill more natural.
Only textured implants should be placed above the muscle because the smooth implants are associated with higher rates of encapsulation when placed above the muscle.
Patients with little breast tissue and very thin skin are better off with submuscular placement of the implant.

I know this is a lot of information but I hope it helps you during the decision process. Good luck!

Form Stable Vs. Round

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The vast majority of American surgeons feel uncomfortable using form stable, anatomically shaped implants, and hide behind misleading information regarding rotation (a phenomenon that occurs less than round implants have malposition drop out), or appearance (that they look the same as round implants). The data is clear: they are the best performing lowest risk implants available.  

Choose form stable implants if your goal is to achieve a long term good looking result with the least risk of rippling or change in shape or position of the implant. In my mind, I think every woman wants this!! 

Form stable devices require the most meticulous of preoperative sizing, inframammary incisions, and a carefully made pocket that will allow the planned implant to fit like a 'hand in glove': very snug.  An experienced 'gummy bear' surgeon does not use 'sizers' in the operating room to 'figure out' the right implant for his patient, necessitating the repetitive placing and removing of temporary devices, causing unnecessary trauma to the pocket as well as increasing the risk of contaminating the pocket, leading to an increased risk of capsular contracture.

Regarding placement, the lowest risk of implant visibility, rippling, and capsular contracture occur when placed below the muscle. The downside is some women experience dynamic changes during pectoral contraction that deforms or causes motion of the implants.  This occurs with severity in a small portion of women, but occurs to a small extent in all women with subpectorally placed implants.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Going with teardrop gummy bear

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Although you haven't provided any details of your history, there are specific indications for having gummy bear implant placed; remember that going with an oblong shaped implant, you put yourself at risk of implant rotation which will cause breast asymmetry. If you are young and physically active, you are at even more risk of this. The only reason to get the gummy bear implant is if you are at a high risk for rippling; this term refers to being able to literally see and feel your breast silicone implant through your skin. This is caused if you are really thin and have thin breast skin. I would recommend that you consider an INSPIRA implant which is firmer than traditional implants yet round and not prone to rotation issues.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 108 reviews

Implant size and shape

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Choosing the right size and shape implant depends on any number of factors all of which require an in person exam. Do keep in mind that gummy bear implants can rotate which is downside. But they are good if you are at a high risk for rippling. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Should I get "tear drop" shaped implants?

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Your question does not provide enough information to give you any real specifics on whether or not you are even a candidate for shaped implants. In fact, the majority of women are not necessarily good candidates for anatomic implants. If you are a good candidate, they are usually placed under the pectoralis muscle, but not necessarily. In some cases they have to be placed over the muscle. The one true disadvantage of shaped implants is that they can rotate. If this occurs, they have to be replaced with round implants. While using anatomic implants is great in the appropriate candidate, it is unnecessary. With all of the implant options available currently, the same look can just about always be achieved with round implants.

Orna Fisher, MD
Palo Alto Plastic Surgeon
4.4 out of 5 stars 14 reviews

Breast Augmentation textured teardrop "gummy bear" implants

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The capsular contracture rate is  less below the muscle and what you are giving up with the anatomical is the fullness on the upper part of your breast mound that some women desire, the round appearance.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Anatomical or round implants

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Highly cohesive shaped implants (gummy bears) have several advantages over round implants. The taller implant can better correct mild ptosis than round implants. They can create a "one breast feel" as they typically do not move in the pocket. They can feel a little more firm than round responsive gel implants. Below the muscle has less capsular contracture than above. Shaped implants can look more "natural" with a pleasing transition from the chest wall to the implant. They do cost more and can rotate. Rotation in my experience, especially when it is the first implant placed, not a revision is vey low. I have not seen one. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Breast Augmentation textured teardrop "gummy bear" implants?

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Thank you for the question. The best way to determine what size implants is by your breast measurements. It is essential that you consult with a board certified plastic surgeon who will guide you in making the right decision. Implants can be placed subglandular or submuscular. Implants placed submuscular have been associated with less capsular contracture. Implants come in different shape such as round, tear trough, high profile, ultra high profile, moderate profile, textured, smooth, etc. It is best to discuss this with your board certified plastic surgeon. Good luck.

Breast Augmentation textured teardrop "gummy bear" implants?

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I appreciate your question.

The best way to determine implant size is based on chest wall measurements that fit your body. Once we determine that we can choose the profile based on what you want or need to achieve.

Implants under the muscle, there is less risk of capsular contracture. Anatomic "gummy bear" implants tend to give a more natural shape with more nipple projection.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Under vs over the muscle

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Under the Muscle (sub-muscular) – When you hear the words “under the muscle” this actually means the breast implant is placed partially under the pectorals major muscle. Submuscular placement may be more uncomfortable the first few days following surgery due to the disruption of the muscle. The possible benefits of submuscular placement are that it may result in less palpable implants, decreased risk of capsular contracture, and easier to image the breast with a mammogram. Under the muscle placement is recommend for women are are very thin with very little breast tissue. The partial muscle coverage will hide the implant better and help avoid visibility of any implant imperfections such as rippling. The appearance will also look more natural.
Over the Muscle (sub-glandular) – Over the muscle means above the muscle and under the breast tissue. This placement may make your surgery and recovery shorter and you will likely have less discomfort. This placement can provide a slight “lift.” Sub-glandular placement can result in more palpable implants, increased risk of capsular contracture and more difficult imaging of the breast with mammogram. This placement is often recommended for those patients with mild breast sag, but do not want a breast lift (mastopexy) and for tubular breast deformity.

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.