Tear drop or Round Implant? There are so many options to choose from. (photos)

Question

I'm trying to decide if I want a tear drop implant or a round implant. I like the fullness at the top with cleavage. What shape does the gummy bear implant come in? Is it round or tear drop? Or is the round one just another silicone implant? My doctor showed me two different sizes on the Vectra machine and I'm thinking I'm going with the larger size since the implant is going behind the muscle. I just want the right size that is proportionate to my body.

Larry S. Nichter, MD, MS, FACS · Answer

Natural feel is not the only thing women care about. The FDA approved intact silicone gel implants as safe. However, if a gel implant ruptures the implant and any gel should be removed including the surrounding capsule (capsulectomy). IDEAL® IMPLANT offers women natural feel without the risk of silent rupture. Women value the advantages of IDEAL® IMPLANT over silicone gel:Rupture AdvantagesNo silent rupturesSaline absorbed, free Silicone Gel remainsNo MRI needed to detect rupturesLook in the mirror to know implants are intactEasy to remove and replaced if rupturedFiller AdvantagesOnly saline inside for peace of mindSafety of salineNo silicone gel in the bodyClinical AdvantagesYouthful shape/contourLower capsule contracture rateHigher rupture strengthLow rupture rate

William Andrade, MD · Answer

Hello, without a proper assessment it's not possible to advise you about implant types and styles, because your anatomy must be taken into consideration.

Laurence Weider, MD · Answer

You are right.  There are currently many choices to chose from.  That being said, based your your "wish pics" I would recommend round, cohesive gel implants for you.  You want upper pole fullness, which the round implants will provide. The tear drop implants are also more expensive and typically require a longer incision for placement of the implant in the pocket.  If they rotate, they can distort the breast shape.  Of course, you should discuss the implant options with a board certified PS during your consultation.  Best of luck.

Michael E. Decherd, MD, FACS · Answer

Under the muscle it is very hard to tell a difference.  The tear drop introduces the possibility of rotation, which the round cannot do (or at least is doesn't matter).  So they have to be textured, which fail more. Also, the tear drop are a lot more expensive.So I mostly use smooth round.  I sometimes use teardrop when there is a tight lower pole.Also, "gummy bear" is not a standardized term--it really just means cohesive gel.  All silicone implants are cohesive gels, but the tear drop ones are a little more cohesive.Good Luck!

York Jay Yates, MD · Answer

Based on your wish pictures and description of your goals, it is clear that you like a rounded breast and I would recommend round implants for you.  "Gummy bear" is a term used by different PS offices differently.  Most commonly, this refers to a highly cohesive silicone product.  Typically these are tear drop shaped implants although Sientra has a round version with the same fill material that will be available when Sientra is back up and running.  Best of luck.  York Yates, Utah.

Khashayar Mohebali, MD, FACS · Answer

Thanks for the question and pictures.  Based on your desired look and the pictures you provided, I think you would like the appearance of a round implant and not the "gummy bear" implants. The later has more of a shape of a natural breast with less volume on the upper pole.  Get consultation with a surgeon that performed surgery with both and get their recommendation.  Good luck.

Suresh Koneru, MD · Answer

Yes, there are many implant choices and they can become confusing.  In my San Antonio Plastic Surgery practice, we use 3D imaging to help patients see the difference between round and tear drop implants.I would recommend simulating both round and tear drop implants to help you with that decision.  If you decide you prefer the round, you might want to consider one more implant that you haven't mentioned in your question - The Ideal Implant.  It has the benefits of a silicone feel and look without the rippling and unnatural look of a traditional saline implant.

Stacey Folk, MD · Answer

Dear NewMe2015HC,You are not kidding! It is great to have so many choices, but it does become quite overwhelming. There are basically 3 implant companies in the US to choose from, and the differences between them are small, but each surgeon may have a personal preference or make selections based on their different properties patient by patient.Based on your wish photos: I would likely steer you towards a round implant rather than an anatomic because you seem to like the upper fullness. Below the muscle is best for long term softness and future mammograms.A smooth implant is going to have more softness and mobility, and textured implant will be a little firmer and not drop or move over time. Smooth is the most common in the US, textured is more common worldwide. Your surgeon will likely have an opinion here.Some companies have a slightly firmer gel, and some styles offered are a bit overfilled to give more firmness and roundness. Size or volume is best determined by trying sizers on in the office, using a tight fitting tank and full length mirror.Your measurements, exam, and goals will influence the profile choice. This is where the 3D imaging really helps. If you like upper fullness the more narrow based diameter implants (i.e. highest profiles) may not always reach up here as you need to remember that the implants sit on their side. Compare the different sizes as well as different profiles when using 3D imaging.I personally think the sizer volume trumps the 3D imaging when selecting volume. Say you like a 350cc sizer in your clothes, but a 550cc on the Vectra. How you like the look in your clothes should be a much stronger influence on selection, not the naked clinical photo unless your profession involves a particular look naked (if you get what I mean here).Your bra or bathing suit top choice is the final big player in the appearance of your your breasts when presenting them to the world. I personally feel size selection should allow you to have some flexibility, where you have the option of being able to play them up or tone them down based on the situation. As one patient so eloquently stated, "I don't want Friday nights t*ts Wednesday afternoon at P.T.A". My patients never fail to continually crack me up!Best of luck to you on this adventure! Every patient and every surgeon walks into this with a preference, and you seem to really be doing your home work here. These are just my personal opinions, but I hope they are helpful on your fun journey. Sincerely,

Robert Whitfield, MD · Answer

In breast
augmentation I have chosen to spend time reviewing photographs with patients to
fully understand their expectation of size and shape.  Many times this simply raises more questions.  I will make measurements and use the implant
guides to allow the patient to understand exactly the sizes that are reasonable
for their body type and measurements. It is helpful that you have had 3D imaging.  The only issue using a shaped implant is cosmetic plastic surgery if the small percentage of patients who get implant malposition from a slight rotation of the implant.  This doesn't happen with round implants in a way that can be noticed even if the implant is turned over some how.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with  breast augmentation surgery.  Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical. In my practice, the majority of patients with your starting point and goals do very well with smooth round silicone gel breast implants placed in the sub muscular (dual plane) position.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, 
I have found that the use of words such as “natural” or "C or D cup” or "proportionate" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.

Tear drop or Round Implant? There are so many options to choose from. (photos)

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