Pear Implant or Round implant? For Most natural look and feel. (photos)

Thanks for your inquiry. I think you will find that each surgeon has their own indications when they use pear shaped (or "anatomic") implants versus round implants.  Good results can be achieved with both types.  I personally tend to use the pear-shaped ones for breast reconstruction after mastectomy, and for patients with lower nipples, to help perk up the nipples.  For people with normally-positioned nipples I usually use round implants.  

The cohesive anatomic implants have a natural teardrop shape but are stiffer, can rotate out of position, and don't move as naturally when you lay down. For these reasons, many patients still feel the traditional smooth round silicone implant is the gold standard for "natural feel". When placed properly in partially submuscular, dual plane pocket, the results can be completely natural.

The shape of the implant is discussed during consultation. I prefer round implants in many cases.  Yes, the teardrop shaped implants can rotate.

All anatomic implants are textured to prevent movement. Textured anatomic gel implants are more expensive than non-anatomic and thus in my opinion, the benefit is seen primarily in a limited category of patients: reconstruction and cosmetic patients that are very thin with minimal breast tissue and minimal body fat. In addition, the anatomic implants have much less variety in volume and profile available from the manufacturer.The issue of rotation is all about technique. They should not rotate if proper technique in pocket formation is observed. Sagging after breastfeeding when you have implants is dependent on how big the implant is and how much size, weight and volume of your breast changes during breastfeeding. It has nothing to do with the shape of the implant.The gel implant itself will not lose any volume. The idea behind the anatomic implants is to provide a more tapered volume at the upper pole for a more natural look.

A shaped implant can solve certain problems, however they are stiffer in consistency or "cohesive" to maintain shape and do not flow with the breast tissue. A round smooth implant, traditional or non cohesive is softer, and flows and moves depending on your position much as the breast does. To us this is "natural". What is important is that you choose your look/feel, and that your surgeon understand your goal and get the implant right. 

Anatomic highly cohesive gel implants are textured to help prevent rotation.  This is a shaped implant with a natural slope to the upper pole. The insertion of the implant in the proper orientation and in a tight pocket are critical to preventing rotation.  Rotation of these implants are uncommon.  There is no evidence that a breast with an anatomic implant is more likely to sag after breast feeding. The implant will not lose volume over time. Hope this helps.