Are teardrop silicone shape implants no longer allowed to be used in reconstruction surgery?

Your surgeon is correct. Teardrop implants have been pulled from the market. You can still get a wonderful result with standard implants, especially if your surgeon also does fat grafting to the superior pole (the upper portion of the breast) to make a more natural and smooth transition from implant to chest wall. Best of luck.

Dear 2020BCsurvivor,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. There is only one type of "tear drop" or "anatomic" shaped implant that has been pulled off the market and discontinued, and that is from Allergan. The similar shaped or "form stable" implants (also referred to occasionally as "gummy bear") are still available form Mentor and from Sientra. A third manufacturer that is gaining popularity is MOTIVA. Please discuss all of your concerns with your plastic surgeon.

There are several technical points you should keep in mind. A round implant, when properly selected, can still allow for a "natural" appearance but it is indeed the case that the upper pole may not be quite as pronounced with a shaped implant. Proper pre-operative planning should allow your plastic surgeon to select the best implant for you. Best of luck with your future surgery.

Thank you for your great question. This is a common misconception about implants in the US. Once specific manufacturer, Allergan, withdrew their shaped textured implants from the market due to BIA-ALCL. Even in these implants, the risk of ALCL is low, about 1 in 3,000 patients. The two other major manufacturers, Mentor and Sientra, both still have shaped, textured implants on the market and available for both cosmetic and reconstructive breast surgery. The risk of ALCL with these implants is much lower, but still not zero, about 1 in 50,000, to 1 in over 200,000, depending on reports. That being said, I think there is still tremendous value in these implants for the right patient and use them frequently in reconstructive surgery and even occasionally in cosmetic cases where appropriate. Make sure you are seeing a board certified plastic surgeon with implant experience and knowledge about the facts!

Hope this helps!

Dallas Buchanan, MD, FACS
VIVIFY plastic surgery