Can I get a teardrop shape with smooth round implants?

Question

I really like the look of anatomical implants but prefer the feel and lower risks of the smooth round. I prefer very little or no upper pole fullness. I am a 32A, 5'3", 115lbs and want to increase my breast size to be more in proportion with the rest of my body. I am more focused on keeping the shape I want than having the biggest cup size possible. Are there any tips or suggestions on how best to get the teardrop look with smooth round implants? Thanks very much for your feedback.

Gerald Minniti, MD, FACS · Answer

Hello,90% of my colleagues across the country are not interested in using shaped devices for fear of rotation and therefore have no experience with them, only regurgitated misconceptions about the risk of rotation (1/10th to 1/20th the risk of capsular contracture) and the concept that they provide an identical result as round (based on non-scientific surveys in auditoriums).  As for textured devices and the risk of the extremely rare cancer ALCL, the conservative number is 1/30000 that an individual will get the disease (compared to 1/615 that you die in a car accident), and that of all the potential 300 patients that may have gotten it in the last 50 years, there are 9 who died, mostly due to mismanagement and delay. The point that keeps getting missed is that shaped devices keep their shape because they are form stable. So they not only look good in the first 6 months, they look good 10 years later. Best of luck!

John J. Corey, MD · Answer

It's a great question and as I tell my patients, with the correct placement of the implant, in the right position, 95% of the time I can get a teardrop shape using around implant. 5% of the time I need a teardrop implant to get a teardrop shape ...so yes you can get a very natural result with around implant.Now in clarification  to Dr. Desai,  The one board certification you should really be certain of is the American Board of Plastic Surgery. ASPS and ASAPS are societies, not certification boards,  and membership in their societies is desirable but I feel, not exclusive to patient's choice.  It's confusing but I hope this helps !!!

Urmen Desai, MD, MPH, FACS · Answer

Yes, if the implants are placed in a submuscular plane.  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) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

Ronald J. Edelson, MD · Answer

Teardrop implants need to be textured to prevent them from spinning the wrong way, which can't happen with round implants. I don't care for teardrop implants.  They have had problems and there really is no advandatage.  Plus they're more expensive.

Jed H. Horowitz, MD, FACS · Answer

Tear drop vs round implantsI am one of the few doctors who believe that shaped implants make a difference, based on my own paitents who have gone from round to shaped implant exchange.That being said . using a softer implant with better (flow) and staying with a smaller volume may allow the gel to drop to the lower part of the breast when you are standing.  It also depends on the shape of your breast to start

Daniel Barrett, MD · Answer

Dear phoenix42,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, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Farbod Esmailian, MD · Answer

Depending on the profile of round implant used, yes, a very natural "anatomic look" can be achieved without the use of using Memory Shape or Natrelle 410.This obviously depends on the volume, measurements, profile of the implants in respect to your body's measurements. A good way to assess a surgeons ability to provide natural looking breasts is to view their before and after gallery.  Also make certain that the surgeon you are inquiring with is a board certified plastic surgeon.Hope that helps.

Stuart A. Linder, MD, FACS · Answer

Using a moderate plus profile round implant will help you to achieve a natural result from your surgery. Best of luck

Donovan Rosas, MD · Answer

Most patients will do fine with a round device. Round devices assume a more tear-dropped shape when placed submuscular due to the pressure of the muscle across the upper pole. The "bolted on" or "stuck on" look is more commonly associated with subglandular placement which is characterized by upper pole roundness.
In my practice, shaped anatomic implants are reserved for reconstructive cases (for a number of reasons including: increased cost, risk of malposition/malrotation, stiffness, BIA-ALCL). Additionally, recent studies show that most surgeons and patients are unable to distinguish between shaped and round devices post operatively with equivalent satisfaction rates.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Tim Sayed, MD, MBA, FACS · Answer

Thanks for your question. The answers of other surgeons fall approximately in line with the statistics that the overwhelming majority of plastic surgeons use smooth round implants most of the time. The reasons for this are as follows:1. A round implant has no real potential for malrotation (a circle can spin around its axis and still be a circle) and while experienced surgeons do not see a lot of malrotation with shaped implants because we are experienced in making the pocket properly, it is still a risk fairly unique to shaped devices2. There are increased risks of ALCL (an EXTREMELY rare cancer) when using textured devices3. Textured devices cost more on averageOne of the surgeons here is pretty adamant that our colleagues are simply repeating mantras that we hear in academic presentations, but the reality is this: most of us do not have epidemics of patients saying "I told you I wanted a teardrop shape but you convinced me to use round implants and now I'm unhappy." If the implants you select are not too large for the patient's chest wall and breast tissue characteristics, and the skin is stretchable enough to allow the implants to pull the skin down a bit with settling, and the implants are not put into a subglandular position (rarely done nowadays), one can certainly have a result with little upper pole fullness with round implants. Physical exam in the office is the best way to determine this. Also, we use surgical simulation software to help take this kind of guesswork out of the process for patients. I find it VERY useful for managing the expectations and properly selecting a device in partnership with my patients.I do think shaped implants may be best for patients undergoing breast reconstruction after mastectomy as the round implants in the absence of any breast tissue may not give as natural a sloping in the upper pole but this is a VERY different situation from cosmetic primary breast augmentation.

Can I get a teardrop shape with smooth round implants?

Answers (16)

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