Choosing between Round & Anatomical Breast Implants.

Although we’re primarily a breast implant sizing service, we get asked a lot of other questions by our patients. One of the more common questions is “which are better, round breast implants or anatomical breast implants?”
The short answer is: This time there is no short answer!

The long answer is, as usual, not which is better, teardrop or round, but which is best for you.

The basics.

Anatomical breast implants (also known as teardrop breast implants) were invented about 15 years ago by implant manufacturers who were responding to women asking for breast enlargement, but wanting to still look ‘natural’. The implants were thinner at the top, and fuller at the bottom, just like the shape of a natural breast.

To make the anatomical implants stay in that teardrop shape they are always filled with ‘form stable’ ( also called gummy bear or cohesive gel) silicone. To make the implants stay ‘the right way up’ once they’re inside your body, the silicone ‘baggy’ of the implant is always textured, so the implant ‘velcros in place’ and cannot shift at all or rotate (ie putting the thin part at the bottom, and the full part at the top…not good!)

Round implants are symmetrical all the way around. They don’t have a ‘top’ or a ‘bottom’, and so it doesn’t matter if they rotate or shift around a little bit inside your body, in fact it can be good if they do. Round implants can be either textured or smooth, and can be either filled with cohesive gel, or runny gel, or saline.

What sort of look are you after?

The first thing to point out, is that the main determinant of how ‘natural’ or not you will look afterwards, is how big the implants are that you choose, and how much natural breast tissue you started with. If you already have a C cup, and add a small implant, regardless of the exact type of implant, you will get a natural result. If you start with an A cup, and add a very large implant, you will get an unnatural result.

These days, some women are quite happy to have an ‘unnatural’ result, in fact they ask for it.

The number 1 factor that makes breasts look ‘unnatural’ is the ‘shelf effect’. In a side on photo, you see the collar bone, and the chest flat below that, and then boom, all of a sudden the breast starts. Natural breasts, out of a bra, start gradually, not suddenly.  (Our all time favourite euphemisms for this ‘shelf effect’ are ‘bolt ons’ and ‘Tori Spellings’).

A real life example.

But to explain further, let’s use an example. Suppose we’ve decided on using a 350cc implant, in someone with an existing B cup who is 160cm and 55kg. That’s a medium implant for someone that size, definitely big enough that issues about ‘naturalness’ need to be considered. What would be the difference between using a 350cc round implant vs a 350cc anatomical implant.

A 350cc anatomical breast implant in that patient is going to result in less ‘upper pole fullness’, and less ‘shelf’ compared with a round breast implant. Now having said that, a lot of upper pole fullness you might see in photos (and like the look of) of is 90% due to a great bra or bikini, lifting the breasts (and implants) up. So let’s understand, when we’re talking about ‘natural’ and ‘upper pole fullness’ and ‘wow factor’, we’re only talking about what your breasts look like naked. For most patients, this is actually less of a consideration than what they look like in a bra, swimmers or clothes.

A 350cc round implant is going to firstly have a bit more ‘upper pole fullness’. How much more? Less than you imagine. When a round implant is inside your body and you are lying on your back, the filling is spread out evenly inside the implant shell or ‘baggy’. When you stand up however, most of the filling falls to the bottom of the implant with gravity. The top of the round implant is thinner, the bottom of the round implant is more full, and the round implant becomes more of a teardrop shape anyway. With smooth round implants, this ‘teardrop effect’ may be even more pronounced because the implant itself may drop down a little bit inside your body, just like natural breast tissue would ‘sag’ a bit when you stand up.

The difference in the amount of ‘upper pole fullness’ will also be affected by whether or not the implant is put under the muscle or on top of it. When an implant is under the muscle (or dual plane), the muscle only covers about he top 1/2 of the implant. The pectoralis major muscle presses down on the top half of the implant and will ‘squish’ the filling down into the bottom half.

So a round implant, placed under the muscle, when you’re standing up, might be only just a bit less ‘natural’ than an anatomical implant.

Problems with anatomical breast implants.

Anatomical implants are slightly more expensive compared to round. Depending on your surgeon’s experience, they may use a slightly longer incision to place anatomical implants. But the real problem with anatomical implants is that until they ‘velcro in place’, they may rotate. If the ‘heavy end’ of the implant moves by as little as 10 degrees, this may result in visible asymmetry of the breasts. The risk of the implant moving out of place (malposition) is higher if the implants are placed under the muscle or dual plane.

Benefits of anatomical implants.

Anatomical implants are most useful in patients who are asking for a big (for their size and tissues) implant, but at the same time are wanting their breasts to look as natural as possible. These patients firstly need a lot of discussion…big implants and natural are not compatible! But once they’ve decided on a certain size, going for anatomical may get them a slightly more natural result. Returning to our example, suppose we’ve decided this patient must have implants ‘on top’ of the muscle. They’re a body builder with a very thin skinfold thickness. They don’t agree to have a 300cc implant, but insist on a 350cc. They want their breasts to look as natural as possible in a posing bikini (which won’t have any built in support). They’re probably going to get closer to their specific goals with an anatomical implant, provided they accept there are some small extra risks.

Conclusion.

Most of the time, in most patients, anatomical implants do not provide much advantage, and may have some disadvantages.

Don’t fall for the marketing trap of believing that because anatomical implants are more expensive that they are somehow generally better.

Ask your surgeon to see examples of both anatomical implants and round implants, as some surgeons only use one or the other. Ask your surgeon to explain, given a choice between 2 implants, both the same size, type and position, but one round and one anatomical, how much (or little) difference using an anatomical implant would make in your own specific case.

 

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