Anatomical vs round and silicone gel vs gummy bear implants? (Photos)

I am 35 years old and breastfed 2 kids and I want to get a breast augmentation and achieve a natural look and soft feel. I want to avoid the top of the implant to be very round and fake looking. I am aware that my nipple to inframammary fold is short and I don't want to be bigger than a C cup. Which implant shape and material would be best for me to achieve the above desired goal with a centered nipple ?

Doctor Answers 7


Both are good choices. I usually use round smooth implants for most patients. It is a discussion that you should have in person with your surgeon.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

Experience of the surgeon matters

Recently at one of our national scientific meetings, plastic surgeons were asked if they could identify a round implant from a shaped highly cohesive implant based on the post-operative photos. The bottom line is that a properly sized round implant in the right patient can look natural and anatomic, and an oversized, incorrectly positioned anatomic implant can look round, high, and fake. Finding a surgeon who knows how to size a patient and perform the operation properly is probably far more important than the exact cc's or implant shape. 

 There is no one right implant for any patient. There are several choices, both round and shaped that will work for your specific dimentions, soft tissue coverage, and desires. What matters most that you find an experienced surgeon who will provide you with a good education on the benefits and risks of each type of implant, demonstrate what you can look like with the Vectra 3D imaging, and perform neat, dry, surgery. You are fortunate that you live in Toronto where there are many very experienced and talented breast augmentation surgeons.

Caroline Glicksman, MD
Sea Girt Plastic Surgeon
4.6 out of 5 stars 10 reviews

What is the best choice?

Thanks for the good photographs, this is what I see:

  • Slight tubular deformity
  • Lack of upper pole fullness
  • High breast crease (short nipple to inframammary crease)
  • Right breast larger than left
  • Wide cleavage area
  • Wide chest
  • Small/average body build
  • Left nipple slightly lateral to the midline as compared to the right

My recommendation would be for a concentric mastopexy/augmentation (donut mastopexy) with round, moderate plus, silicone gel implants under the muscle, approximate size-400 cc. This approach should correct all of the above issues.  Of course, all of this would depend on patient desires, a detailed history and physical examination with photographs, measurements, scar discussion, cost and down time.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Implant options

It's difficult to say without having a long thoughtful discussion ,consultation and examination.  However, just based on what you're requesting, and the "look" you are going for, I would recommend a gummy bear teardrop shaped implant.  Make a few consultations to get a few different opinions in person.
Best of luck!

Dr. Subbio
Board-Certified Plastic Surgeon
Newtown Square/Philadelphia, PA

Christian Subbio, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 65 reviews

Anatomical vs round breast implants?

Thank you for the question. These days there are a variety of breast implants available; the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally, I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).

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. ***Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.

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 cup" 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 for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Anatomical vs round and silicone gel vs gummy bear implants?

You have good breast anatomy and should e able to achieve a very nice result with either type of implant under the muscle.

For what it is worth 83% of board certified plastic surgeons use smooth round silicone implants-as the implants drop they create a natural look. When you see implants that look like "round balls" it means that the patient has a capsular contracture or sub optimal surgery.

Focus on finding the best surgeon that you are comfortable with and let your surgeon recommend the type of implant that he or she feels is best.

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.