Anatomical or round? So confused now!

I've now seen three board certified surgeons and each one has given different recommendations! I'm going ahead with implants without a lift (at this stage) but want to know what would be best to acheive a lift and upper pole fullness whilst still looking natural? 2 surgeons recommend round implants and the other wants anatomical. I will be going subfascial. why are are they giving different opinions I get more confused each time I go for a consultation and want to go ahead with surgery in July.

Doctor Answers 8

Anatomical or round? So confused now!

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Based on your photo, you seem to be suitable for either shapes. More than the implant shape and size is the procedure. If your surgeon could perform the procedure very well then you'd have a great result regardless of which implant you choose. Make sure to consult with a board-certified plastic surgeon.


London Plastic Surgeon
5.0 out of 5 stars 10 reviews

Anatomical or round?

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Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a BBL Always insist on a board certified plastic surgeon.

Round or anatomical implants

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Hi there. This is a commonly debated issue and in most patients, it probably does not make any difference - most plastic surgeons cannot even tell the difference according to recent studies. My own  experience suggests that the only indication for anatomical implants is in patients with minimal natural breast tissue undergoing subfascial implant placement - that may be your situation but it is impossible to tell without an in-person consultation or photographs. Good luck! 

Round or anatomical?

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  Thank you for this extremely important question and one that I get asked all the time in clinic. Unfortunately, this is a very complex and subtle argument and I don't think any surgeon is going to be able to give you a really clear answer in this forum  what is right for you personally.  What I can say is that the difference is probably less than you've been led to believe so far. Anatomical implants can look very natural but can also look quite round. Used correctly, round implants can also look very natural. It depends more on the tissue characteristics, the amount of breast tissue and subcutaneous fat, as well as the size, placement and tightness of the pocket.

 One thing I can say is that breast implants do NOT 'lift' the breast. What they can do is give the illusion of a lift and perkiness by filling out the envelope and you can see this on certain before and after photos.  Any reputable surgeon should be able to find an example similar to you illustrate the sort of change you can get but I have also found 3-D imaging to be invaluable in demonstrating these issues. The Vectra system is far superior to any other on the market and I would urge you to have a consultation with the surgeon who can offer this service. Good luck. 

Anatomical or round?

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Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices. It is quite amazing how adamant each plastic surgeon can be about the superiority of his/her recommendations…


Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon carefully. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. If I were you, I would ask to see as many examples as possible of similar patients who your plastic surgeons have helped.


Based on your photographs, I would be concerned that you will not be pleased with the results achieved with breast augmentation surgery only.  Do not expect any type of breast implant to "achieve a lift" for you.


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 smooth round saline or silicone gel breast implants for the vast majority of patients.

Best wishes.

Breast Implant shape selection

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Hello, 

I am not surprised that different doctors gave different opinion. The reason is , that breast shape after the implants , less  dependent on shape of implants, and more on other factors like your tissues and and surgical skills . There are pros and cons in both type of implants. Therefore choose the surgeon you trust the most, and who has understood your needs. You can ask her to show the pictures of her similar patients.

Priti Shukla, Mch
India Plastic Surgeon
5.0 out of 5 stars 38 reviews

Rounds vs anatomics

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Hi. Opinions will vary - there are many ways to achieve a similar goal. In your case, without pictures, it is impossible to comment or give an educated opinion. That said, in the overwhelming majority of cosmetic breast augmentation patients that I see, I can achieve very good results using textured, round breast implants, rather than anatomics. Anatomics may seem like a good idea, but are not without short and longer term potential "issues". Most women in my practice want a full upper pole (still "natural" though) and this can easily be achieved with a suitably projected round implant, in my experience.

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

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I appreciate your question!

After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

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

Board Certified Plastic Surgeon 

#RealSelf100Surgeon

#RealSelfCORESurgeon

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.