Sientra Tear Drop vs Smooth Round Implants and Size(s) for petite women?

I use textured anatomic implants on thin women almost exclusively since in thin small breasted patients the implant shape makes a huge difference in overall shape. Most American surgeons do not share this opinion but I think they are just too use to the fake look round implants give you

I believe Sientra only makes smooth round implants. Teardrop implants are mostly used in reconstruction. They can tip over, requiring more surgery. They also need to be rough on the outside, which may cause other problems. Any smooth round implant will settle into the shape of a teardrop, usually within 6-12 weeks.

Plastic surgeons have differing opinions on this. However, let me give you my personal belief. There has never been a study that showed that teardrop shaped implants give a better result than round implants. Teardrop shaped implants all have textured shells, because the texturing helps the tissue stick to the implant so that it does not rotate inside you. If a teardrop shaped implant rotates inside you, you need another operation to correct the rotation. It doesn’t matter which direction the smooth implants rotates, the shape always looks the same. The texturing is also associated with a rare tumor, anaplastic large cell lymphoma. So my feeling is that, if I can get the same result for my patients, I don’t have to worry about the implant rotating and requiring my patients to have another surgery, and I have a much lower risk of my patient having anaplastic large cell lymphoma, I would always choose a smooth, round implant. I hope this is helpful. Best wishes.

Dear Glorious747950,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Shaped devices have been mostly relegated to the breast reconstruction community after mastectomy. Good data shows shaped implants do not offer a different appearance over round of similar dimensions, and they have the extra risk of rotation leading to asymmetry and the need for revision surgery. Further, all shaped implants are textured, which provide an extra (but extremely small) risk of breast implant associated lymphoma.