Anatomical (teardrop) vs round?

Question

All the pictures I'm drawn to are using "teardrop" shaped implants I have been told to use a smaller implant. Under the muscle. Is teardrop the same as anatomical? I do want some upper pole projection but I want a natural look- Not huge breasts! I have a naturally wide BWD with a lot of side boob so I don't want to look matronly. Also having a lift! What do you recommend me? I Want to drop 3-4kg before op no more! I'm5ft5 66kg, 34b/c with a lot muscle/curves on legs & bum.

Farhad Rafizadeh, MD · Answer

You have an ideal breast shape and size for a smooth round implant to give you adequate projection and a larger breast. The textured anatomic teardrop implants will not offer any advantage in you situation. The safest implants would be the Ideal Implant. These are saline implants with the proper profile and shape with an internal structure that will give you the feel of a gel implant, but without the need to do an MRI every 2 years to rule out a silent rupture.

Donovan Rosas, MD · Answer

Gummy bear implants are a variant of silicone implants. The difference being a form stable gel fill which imparts the anatomic shape. Thus your question is more likely to be one of shaped vs. round silicone implants.
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, most will opt for round devices.
The question of "natural" is less a question of implant type and more a question of appropriate sizing (staying within the boundaries as defined by the BWD).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Gregory Turowski, MD, PhD, FACS · Answer

I rarely use tear drop implants (and yes they are also called anatomical or shaped) but in some cases they can be helpful From the presented pictures you might be a good candidate  for an "internal lift" - this way you may correct your borderline nipple position and avoid formal breast lift and associated visible scars

Badar Jan, MD · Answer

A very important question. A anatomic implant gives the most natural appearance of all the implants. Round implants such as a moderate plus silicone implant can also give very nice upper pole fullness without excessive roundness. One other option that is gives a very natural result along with a lift is fat grafting to the upper breast. Fat grafting as an option is more limited to more modest enhancement. I'd recommend an examination with a board certified plastic surgeon to discuss your goals, perform an examination and review photos.

Best wishes,

Dr. Jan

Best wishes,

Dr. Jan

Michael Dobryansky, MD, FACS · Answer

For the look you want the anatomic implant is best. The problem with those is the textured surface and the potential risk of ALCL. The risk is quite low, but most surgeons these days are reluctant to put is textured implants. Most of the confirmed cases of ALCL are associated with one manufacturer's implants which I personally do not use. Another nice choice for you would be a style 107 implant. These and many other choices are best discussed during an in person consultation.

Urmen Desai, MD, MPH, FACS · Answer

For the look you wish, I recommend a smooth, round gummy bear implant.  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), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

Ram Kalus, MD, FACS · Answer

You raise an excellent set of questions and the bottom line is that you do no need "shaped" or "anatomic" or "tear drop" shaped implants to achieve a natural look without excessive upper pole fullness. The look you want is entirely dependent on proper implant selection and this is best accomplished in the hands of an experienced board certified or board eligible plastic surgeon. A breast lift will actually give you more upper pole fullness so you are probably best off with a moderate profile implant with a significantly narrower base diameter than your breast. Best of luck to you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  I recommend round implants which provide good upper pole fullness and do not have the risk of contour irregularities with rotation.  Teardrop implants do have the risk of malrotation deformities.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Kenneth Hughes, MD · Answer

The majority of implants placed in the US are round.  Most women are better suited for a round implant as the breasts usually lack superior pole fullness. Anatomic implants always have the potential for rotating and creating a contour issue.  You can achieve natural results with round implants, so I find very little use for the anatomic implants.  Kenneth Hughes, MD breast augmentation Los Angeles, CA

Brian A. Pinsky, MD, FACS · Answer

Thank you for this question.  Implant selection is often something that patients have many questions about.  There has been no definitive evidence that even educated observers can tell the difference between shaped and round implants.  There are also safety considerations with shaped (teardrop) implants that are not as much of an issue with round implants.  Shaped implants all have a textured surface to help them stay in the same position and not rotate in the pocket.  This texturing has been lined in a very small number of cases to ALCL.  Also, round implants are expected to rotate freely in the implant pocket.  If a shaped implant rotates for any reason, an operation is needed to correct it.
Based on your photos, I would recommend a modest-sized smooth round silicone gel implant.  Depending on the amount and quality of your native breast tissue, the implant could be placed either above or below the muscle.  You don't have ptosis, or drooping of the nipple position, but I will occasionally recommend a periareolar mastopexy to tighten the skin envelope and control areola diameter long-term.  
Your best bet is seek an in-person consultation with a board certified plastic surgeon.  Good luck!