If I want this kind of look should I get tear drop implants? Also what percentage risk do they have of flipping/moving? (photo)

Question

I have textured, round, 265cc, hp over the muscle. Note: I can't have unders btw. I have mild constriction of the lower poles and slightly short nipple to inframmery fold distance. Mysurgeon said he would release the bands internally and do some pocket work. He recommended tear drop implants to fill out the lower pole more (something I desire but don't have now) we agreed on about 400cc. I am scared about anatomicals flipping. How common is this?Can I get the look I want with rounds?

Kenneth Hughes, MD · Answer

Some doctors believe that the teardrop shape creates more fullness just at the bottom of the breast. It is true that the anatomic implants always have the potential for rotating and creating a contour issue.  When placed by an experienced board certified PS, round implants can achieve a more natural breast shape than teardrop. If round shaped implants flip they will keep their shape in any direction; tear drop will not. I have seen estimates of between 3% and 14% of patients who experience rotated implants.

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 or revisionary 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 "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 helps. Best wishes for an outcome that you will be very pleased with.

Donovan Rosas, MD · Answer

Tear drop/anatomic/shaped implants are a variant of silicone implants. The difference being a form stable gel fill which imparts the anatomic shape. The "gummy bear" gel is the most cohesive/firm available. It is form stable and will hold a shape thus the shaped/gummy bear. Additionally, these devices are textured as orientation is crucial (a tear drop is only a tear drop when oriented appropriately). The texture acts as a sort of velcro holding the implant in position.
In my practice most patients will choose a smooth round device. When placed in the submuscular plane, the aesthetic differences are minimal. The downward pressure by the muscle across the upper pole of the round device forces it to assume a more tear drop appearance. Recent studies have shown that both patients and surgeons have difficulty distinguishing between the 2 implant types post-operatively. Additionally, shaped implants are more costly and have an increased risk of rotation.
Finally, although very rare, the few documented cases of BIA-ALCL (Breast Implant Associated Anaplastic Large Cell Lymphoma) have all been in cases of textured devices. Until more data is available many are shifting their practice back to smooth round devices.
Studies have shown most cannot tell the difference between the shaped and round devices when placed submuscular. In light of the added cost (2x), larger incision, and BIA-ALCL risk...most will opt for round devices placed beneath the muscle.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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Daniel Barrett, MD · Answer

Dear Eleanoradoll,
Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jonathan J. Staiano, FRCS (Plast) · Answer

Hello Eleanor,This is a difficult question to answer and would be best addressed with an in-person consultation.Teardrop implants do run the risk of rotation and so this risk needs to balanced against the benefit in terms of the difference in shape with less fullness in the upper part of the breast.  You could consider polyurethane foam implants which are much less likely to rotate than textured silicone implants.I would be concerned about going bigger and going teardrop.  For a given base width, a teardrop implant will tend to be smaller than a round implant.  This means that if you are going for a 400cc teardrop implant, it is likely to be quite a bit wider than your 265cc round implants.I would always advise caution about going too wide with your implants as this can cause problems (synmastia, lateral fullness).  This is why I really think you need to go over everything with a fully trained plastic surgeon - look for the letters FRCS(Plast) after their name.Good luck.

If I want this kind of look should I get tear drop implants? Also what percentage risk do they have of flipping/moving? (photo)

Answers (9)

Answer: Implant size and type

Answer: Implant size and type

Answer: Risk of rotation of teardrop implants, but there are benefits too.

Answer: Risk of rotation of teardrop implants, but there are benefits too.

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Everything you need to know about Breast Implants

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If I want this kind of look should I get tear drop implants? Also what percentage risk do they have of flipping/moving? (photo)

Answers (9)

Answer: Implant size and type

Answer: Implant size and type

Answer: Risk of rotation of teardrop implants, but there are benefits too.

Answer: Risk of rotation of teardrop implants, but there are benefits too.

Browse related questions

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.