One of the oft quoted complications of using anatomical (shaped) implants is the possible rotation or displacement of the implants. For this reason the shaped implants have been textured on their surface to help prevent this displacement. As others have pointed out accurately though, this doesn't always solve the problem, and therefore, if one is going to use those implants, in my opinion, the key is in the technique used to create the pocket. In my experience, one of the most important factors in using ANY implants is the development of the pocket. Any breast implant, round or shaped, can slide or rotate if the pocket is not properly developed to fit the implant and control where it goes; it's just that with anatomical implants this may be more apparent because there is less margin for error due to the shape of the implant. If a round implant rotates it has little effect on the shape of the breast because it is round, and it has the same shape no matter what its orientation on the chest wall. If a shaped implant rotates, the long axis may be oriented at an unnatural angle, and this may be apparent and affect the shape of the breast. These implants have been used successfully in Europe for years, and those surgeons who use anatomical implants successfully find that the key to their success is a careful and meticulous creation of the pocket using a direct approach - that is through the areola or under the breast - armpit, or transaxillary, and belly button, or transumbilical, approaches won't work. I have seen beautiful results in patients with these implants, and I think they are a definite plus for ladies who have very small breasts or thin tissues and who want a more natural, gradually sloping, gentle contour to the breasts as opposed to the full, round, often artificial appearing shapes that we see with round implants, especially in the larger volumes. If you want the "Baywatch breast" look, then most certainly go with a round implant - maybe even high profile - but if you want a more natural appearance, then a shaped implant may be better for you. I'm not saying that shaped implants will replace round implants at all; in fact, on the contrary. I believe that still the majority of implants used, even in my own practice, will still be round. But for those cases in which a shaped implant has definite advantages, I would not hesitate to use it, nor should those patients hesitate to have them placed on the basis of the implants alone. In addition to the obvious shape advantages, there are some other advantages that are coming to light with the newer shaped implants recently available on the US market with regard to rupture rates, as the shaped silicone implants are cohesive gel, and the capsular contracture rates, as the texturing of the implants has some effect on the rates of capsule contracture. Thus, in my opinion, the question is not about the implants themselves; the question is whether your surgeon feels comfortable that he or she can pull it off. Good luck!