What Are the Benefits of Anatomical Breast Implants over Their Round Counterparts?

What is the difference between smooth and textured surfaces for breast implants?

Doctor Answers 13

Shaped Breast Implants

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Shaped, form stable breast implants used today are very different  than the first generation of tear drop breast implants. All shaped implants are textured to avoid rotation. Sientra uses a proprietary method of texturing called True Texture that has a proven track record internationally over the past 20+ years. In the FDA clinical trials Sientra had zero rotations, and 4.9% rupture rate. Mentor uses a stamping method for texturing that has uniform shallow groves in the implant called Siltex. In the FDA trials Mentor had a 3.4 % rotation rate, and rupture rate of 10.6% . 

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Anatomical or Round Implants?

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Thank you for the question.
Anatomical breast implants were designed to better simulate the natural breast  shape;  the problem with these implants is that if they shift or rotate,  the entire breast will change shape as well.  This change in breast shape may require further surgery to correct.
Round implants, under the hand, can shift or rotate without changing the shape of the breasts.
Smooth  and textured surfaces refer to the breast implant surface characteristics;  some surgeons prefer one over the other.
I personally prefer the use of smooth  and round implants for most patients.
I hope this helps.

Texturing has lower capsule rates

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Texturing has lower capsule rates over the muscle. They're required for anatomical implants so the implants are less likely to flip or twist in the pocket (think velcro). Anatomical implants can have a less round upper breast shape when compared to high profile round implants as well.

Round vs. Anatomic shaped implants

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It really depends upon you shape if  you were to choose a round vs. an anatomic shape implant.  If you have a well formed breast just insufficient volume then you would do well with a round implant.   From the shape of your breast you will do fine with either implant.  Vectra 3 D imaging is a great educational too which helps patients visualize the difference between all of the implant choices  > 500 types and sizes.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Anatomic implants

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I used anatomic implants a lot many years ago and really learned to hate them.  They add complexity and subtract predictability.   I ended up doing a lot of revisions on these patients and often switching them to round implants.   

Also, I think most of us would be hard pressed to identify patients with round vs anatomic implants.  There was a paper to that effect presented by a resident at the Northwest Society of Plastic Surgeons annual meeting several years ago.  Even very experienced plastic surgeons could not tell the difference!  Also, round implants assume an anatomic shape when the patient is upright unless they are really, really overfilled. 

I really think the anatomic implant push was a marketing thing. 

As for anatomic gummy bears, I have zero experience with them so they may add a whole new dimension to the anatomic vs round debate. 

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

What Are the Benefits of Anatomical Breast Implants over Their Round Counterparts?

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As you can read the posts of the previous experts the majority are against use of the "A" implants. As am I. Also the coverings are used for fixation and decrease capsule formation but the textured implant ripple more. 

Anatomical implants

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The intention of anatomical implants was to mimic the shape of the ideal breast.  They are supposed to enhance the lower half of the breast greater than the upper pole of it.  Similarly, because they have an upper pole to their design, it is intended to a lesser degree to be an area of enhancement.  They are textured so they don't rotate.  Most of us don't have accest to these breast implants yet, so in my mind, they're still controversial.


Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 125 reviews

Anatomic implants over other choices

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I am not a big fan of the "anatomic" or biodimensional implants. First they have a polarity or an up and a down. This means that if the implant turns it will look funny, and it usually requires surgery to turn them back.   They are also textured which can cause more ridging.    After a few months if they are in proper position, they will be difficult to distinguish from round implants. Oh yeah, they are also more expensive then the round ones.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Anatomical Implants

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I used to use primarily the anatomical implants in my practice 15 years ago but quit.  Because of their shape they tend to give too much superior fullness in many patients creating a "step off".  Because they can shift in position and give a bad appearance they are textured to hold them in position.  Because of the texturing the shell is thicker and this makes them firmer to the touch.  The texturing also increases the chance of visible rippling.  I would never recommend them too a patient anymore.  The last patient that I put them in because she insisted on them had me replace them 6 months later because she was having every one of the above issues.  After over 2000 augmentations I think the round smooth implant is the best implant.

There is a shaped gel implant that is not available yet that may be better.

Gary Hall,MD

Gary Hall, MD (retired)
Kansas City Plastic Surgeon

Anatomic Implants, Textured Implants

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Because anatomic implants have a very specific shape, they must have a textured surface which allows the body's scar tissue to adhere to them preventing movement. A good study was done years ago asking plastic surgeons to examine patients without knowing which implant was used in their augmentation. They could not tell a visible difference unless the anatomic implant had failed to adhere and rotated to a distorted look. Even on mammograms at one year radiologists could not tell the difference. In todays implant world, there is almost no benefit to a textured anatomic implant. In my practice I see several women each year who have received these devices and are unhappy. We replace them with a smooth round implant.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.