Can mastectomy patients get a nice result with round implants or would "anatomical" teardrop shape be better? (Photo)

I had a mastectomy and was advised by my surgeon to go with silicon teardrop implants, but they feel heavy and rigid to me. When I felt the smooth, round implants they felt softer, lighter and more pliable, which I like. I am concerned that since I have no fat in my chest that the rounds might look too "severe" and have an obvious outline. My surgeon is also concerned that I don't have enough fat for fat grafting. My exchange surgery is in 8 weeks and I'm trying to decide between the two types.

Doctor Answers 6

Implant types in breast reconstruction

This answer is always evolving as implants evolve. If you are thin, and your bones show right through your chest wall (check out the  collarbone!), then chances are that you will have some rippling, whichis seeingthe implant through the skin. The advantage of shaped cohesive gel teardrops is that they really don't ripple much. The disadvantage is that they are really stiff and have an "edge" to them. Also, in real life, breasts don't have the same shape no matter what, as these implants do. Since smooth round cohesive gels came out (like Allergan's line SRF/SRM/SRLP etc) I've been using these on my skinny women often, and everyone seems very happy with them, as they ripple a little more but not as much as the old gels like style 10,15, and 20's. My current practice is to let the patients feel them both and decide for themselves, as well as telling them the information I just gave you. Everyone gravitates to one or the other immediately. As for your fat graft, if you can just get 20 or 50cc it would make so much of a difference. It will be better than the TE for sure!!! Best of luck!!!

Beverly Hills Plastic Surgeon
4.7 out of 5 stars 13 reviews

Can mastectomy patients get a nice result with round implants or would "anatomical" teardrop shape be better?

The final decision is definitely up to you and what you think you will be happy with. What I can tell you is I personally would choose an anatomic implant. They do feel rigid but soften with time. It takes ~3-4 months but they do soften and tend to feel more natural. They are also textured so they don't move, but look more natural versus a round implant. 

Erika Sato, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 90 reviews

Shaped or Round Implants, which is better?

Hi Jphillli, Thanks for your question and photos. Based on your photo, it seems that you have rippling already. My recommendation based on this fact would be to get shaped implants under the muscle. If not fat is available  then layer another a new piece of acellular dermis to thicken the skin so that the rippling is less obvious. If you go with round the ripple rate is higher. The weight is the same regardless of round or shaped, i.e the 1 pound of feather or lead concept! The shaped implants soften. But ultimately the decision is yours and based on what YOU WANT. good luck!   All the best, Carlos Mata MD, MBA, FACS #breastreconstruction #shapedimplants Board Certified Plastic Surgeon

Carlos Mata, MD, MBA, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 30 reviews

Implant type

I actually am not a fan of the anatomic implants especially in thin women.  In my experience the upper pole of the implant is noticable and patients do find the implants to be too stiff.  Lately I have been using "more filled" implants such as Natrelle SRF style.  The higher fill volume minimizes rippling which can be a problem in thin women.Good luck,Dr. Luong

Jacqueline Anne Luong, MD
Edina Plastic Surgeon
5.0 out of 5 stars 9 reviews

Implant choice for reconstruction

Go with the anatomic shaped implants. It will give you a nicer, more natural shape. Weight of the implant is the same for similar volume silicone implant regardless of shape.  You will benefit from fat grafting of the upper poles and will only need about 20 to 30 ml per side. Potential donor sites can include abdomen, back, flanks, buttocks, or thighs. Best, Dr. Yegiyants 

Sara Yegiyants, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 13 reviews

Shaped vs round implants

This is always the main question to be asked. In my reconstructive practice I do tend to use the shaped implants more, but I'm flexible if someone has a preference. If you're still feeling the expanders, they are not indicative of how the final shaped implants will feel. The permanent ones are much softer. However, they are still a little more firm than a round implant. So there's a trade off. Based on how thin you are, I agree fat grafting is needed if possible. And for the same reason, I think the shaped will look better as they will come off your chest wall more naturally.

Cain R. Linville, MD
Houston Plastic Surgeon
5.0 out of 5 stars 32 reviews

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.