Factors Impacting Breast Augmentation Results
There are many factors that impact the final look and shape of augmented breasts: original breast size, breast shape, thickness of tissue, elasticity of tissue, symmetry, rib contours, history of pregnancy, history of weight loss, etc. So how much of a difference does the shape of the breast implant make? This question can be a source of anxiety for many breast augmentation patients as they consider whether to get round implants or shaped ones. Fortunately, a recent study in plastic surgery’s most prestigious journal, Plastic and Reconstructive Surgery, answers that question. Only silicone gel implants were studied, since they have a more natural feel and greater longevity than saline implants.
Difference between Round & Shaped Breast Implants
Many plastic surgeons and patients alike assume that the shaped, sometimes called “anatomic” or “anatomically shaped,” implants look more natural than round implants. On the other hand, surgeons using round implants point to gravity as contributing to the final shape of round implants. The main difference between shaped and round implants is where the “peak” is, or the point of maximal projection. That peak is off-center in the shaped implants, and it appears at a lower level when placed in the body. Ideally, that point of maximal projection lies behind the patient’s nipple. That off-center peak sounds like a great idea, but if the implants turn, that peak can rotate into the upper part of the breast, distorting it. (Turning of the implant is called a “malrotation.”) A malrotation happens in up to 14% of patients. Of course, because it’s perfectly symmetric, rotation of a round implant has no effect on the shape of the breast. There is another difference between round and shaped implants: cost. In the United States, shaped implants are about twice as expensive as round implants, which is a further disincentive for patients to request them for breast augmentation. Of course, if shaped implants were to offer a better result, then the risk of malrotation and the cost of the implants would be worth it to many patients. So is there a difference in the look of the breasts with shaped versus round breast implants?
Is Breast Implant Shape Detectable?
To answer this question, the investigators compared smooth and round implants that were all 340 cc’s or less in volume. All breast implants were placed beneath the pectoralis major muscle (“submuscular” placement). Fifteen plastic surgeons and 15 nurses were asked to determine implant shape as they looked at before-and-after photographs of 15 women with round breast implants and 15 women with shaped breast implants. Were they able to tell the difference? No. They were as accurate as if they had chosen by flipping a coin. The round and shaped breast implants were indistinguishable. The authors concluded: “The use of anatomically shaped implants is not justified because, besides having a higher cost, there is a risk of malrotation with no benefit over round prostheses”.
The decision of what breast implant to choose before a breast augmentation can be difficult, but this article makes that choice just a little bit easier. Choosing a board-certified plastic surgeon with good before-and-after breast augmentation results is the most important first step. The experienced surgeon listens to a patient's goals and reviews what is and isn't possible with a breast augmentation. The well-informed patient in the hands of an excellent surgeon is the best combination for a good outcome.