Booked for anatomical - can the same result be achieved with round? (Photo)

Question

Hello! I’m booked in for a BA next month. I want a super conservative/ natural result. Not a big increase in size; more just want to improve shape after BF. I’m currently a small B cup. My doctor has ordered 3 anatomical sizes: 160cc, 180cc & 220cc, all low profile. While I was set on anatomical originally because I don’t want that upper pole fullness/roundness, I’m wondering if I was too quick to pass on round. My main concern is rotation. Can the same result be achieved with round?

Zoran Potparic, MD · Answer

Based on the experience of many plastic surgeons who perform multiple breast augmentations, it does no look that there is much of the difference between two implants in the long run.  Good luck.

Ted Eisenberg, DO, FACOS, FAACS · Answer

You are right, with the risk of rotation there is no advantage. Regarding size-After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear Fierce984128,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Carlos Marciales, MD · Answer

The trouble in your breast it’s that your upper pol it’s empty, if you use anatomical, it will look empty, you need round, also, I don’t know how big it’s your back, but the low profile we used in patients with a wide tórax cage, I don’t think it’s your case, I think you will look much better with a round implants, medium or high profile

Camille Cash, MD · Answer

Yes you can achieve a natural result using round implants.  If you select an implant with a lower profile there will be less upper pole fullness and projection.  Placing the implant beneath the muscle also will help add to a natural look

Connie Hiers, MD, FACS · Answer

I only use round implants for breast augmentations and they are all somewhat teardrop in shape when standing. The round have less long term risks and work very well.  Yes, you can use round.

Mytien Goldberg, MD, FACS · Answer

As a prospective breast augmentation, you should be aware of several unique problems with Anatomic implants. The most commonly known problem is rotation. I have seen this problem in patients done by other surgeons and to fix the problem, it requires revision surgery. Secondly, a less talk about problem that every woman should be aware of is that these shape implants are textured implants. Texture implants have a unique risks of Breast implant associated atypical large cell lymphoma (BIA-ALCL). It is a real cancer risks that is unique to texture implants. Therefore I think for a cosmetic procedure, a patient should not have this added risks of BIA-ALCL. That being said, round smooth implants can give you a natural slope results similar to shape implants given the right profile. An important fact, a blinded study of round versus shape implants study show that even among plastic surgeons, we can only correctly tell whether a shape or round implants in 50% of the time. Looking at your picture, I think you can easily achieve a natural augmentation with a round smooth implant using either a moderate to moderate plus profile. The implants size you listed above are really small for your frame and may not achieve the results you desire. You should ask to see the implants prior to surgery and place in your bra to see if it is the size you desire.

Antonios Mitsakos, MD · Answer

Although there is no set rule as to what type of implants one should use in order to achieve a specific result I understand your concern. Round implants do stop with type and (particularly the sizes you are suggesting) can give very subtle, natural results

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

My answer is yes a round breast implant once it is inside you especially when placed under the muscle the round implant becomes a teardrop shape

There is no need to have an anatomical implant as in my opinion the round implant will achieve the same result.

Furthermore anatomical implants are textured so that the implant can alter shape.  There is evidence that the textured anatomical implants have an association, albeit rare, with an anaplastic large cell lymphoma.  This is a risk I would not want my patient to take.

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