How to Choose the Best Implant Shape for Your BreastsDr. John Q. Cook explains the difference in breast implant shapes.
Breast Implant Shapes – Women Now Have a Wider Variety of Choices
Until recently, women in the United States had a relatively limited range of options for breast implants. The choice came down to whether you wanted a silicone-gel or saline-filled implant and to whether you wanted a high, medium, or low profile implant. All of these implants have round bases, so there is no polarity or direction to the implant.
SHAPED IMPLANTS ARE NOW AVAILABLE
In general these implants hold a specific shape when they are placed beneath the breast and pectoral muscle.
The shape mimics that of the natural breast — fuller at the bottom and tapered at the top. Because of this, it is very important that they be positioned accurately by the surgeon.
Despite the marketing of the implant manufacturers, I do not think these implants will become the dominant type of implant used in breast surgery. I do think that shaped implants are highly beneficial for specific situations.
SHAPED IMPLANTS HAVE SEVERAL CONFUSING NAMES
Implants that hold a natural teardrop shape have been called a variety of names: gummy bear implants, form stable implants, anatomical implants and shaped implants.
The three breast implant companies in the United States, Allergan, Mentor and Sientra, all have versions of anatomical or shaped implants. As of yet there is not the full variety of shapes that have been available in Europe for a number of years, but the size and shape range is expanding.
SHAPED IMPLANTS ARE NOT EXACTLY NEW
Over the years there have been versions of both saline and silicone gel implants that were designed to have a teardrop shape, and I have worked with virtually all of them.
Anatomical saline implants were helpful to a degree, but the problem was that the salt water, which filled the implants, had little resistance to the mechanical forces of the body, so that they didn’t completely hold their shape. Nonetheless, as I look at the long-term results on my patients who had these implants, some women definitely benefited from them.
Earlier versions of shaped silicone gel implants, such as the Becker 50 and the McGhan (now Allergan) 153, had compartments and inner chambers that were designed to maintain more of a tear drop shape. None of them, in my opinion, held their shape as well as the current anatomical implants.
WHAT MAKES ANATOMICAL IMPLANTS HOLD THEIR SHAPE?
With earlier versions of anatomical implants, the shape was determined by the shell of the implant.
In other words, the shell was made to a particular shape, and then the device was filled with either salt water or a relatively pliable form of silicone gel. If you pushed on one area of the implant, the salt water or silicone gel that filled it simply moved to another area, and the implant would lose its original shape. This meant that if there was any tightness in the tissues of the lower pole of the breast, the saline or silicone gel would move upward and create a “top heavy” breast.
With the new anatomical gel implants, the molecules of silicone gel are tightly cross-linked.
As a consequence, the gel that fills the implant independently holds its shape and does not just rely on the shell to create its form.
WHEN ARE ANATOMICAL OR FORM-STABLE BREAST IMPLANTS MOST USEFUL?
In my practice, there are two groups of patients who benefit the most from implants that hold their shape: breast reconstruction patients and women who are very trim and athletic and who want to minimize fullness in the upper portion of the breast with breast augmentation.
For my breast reconstruction patients, form stable implants have been a wonderful advance. The breasts hold a beautiful shape and there has been less trouble with rippling and irregularities. Often I combine the use of form-stable implants with fat transfer to optimize the appearance of reconstructed breasts.
Breast augmentation patients who are very trim and athletic and who have very little breast tissue may also want to consider form stable implants, since these implants tend to hold a natural shape in a variety of circumstances.
Some very trim women who are body builders may not desire implants underneath the pectoral muscles, since contraction of the pecs may cause noticeable deformity. When placed in the plane, over the muscle but under the muscle fascia (subfascial implants), form-stable implants may be of help, particularly if fat transfer is used to soften the upper border.
I have also found anatomical implants to be helpful for some patients who require complex revisional breast surgery.
NOT EVERYONE NEEDS FORM-STABLE IMPLANTS
For most patients seeking breast augmentation, conventional round silicone-gel implants in the plane beneath the pec muscles can create a beautiful breast.
Remember that the pec muscle drapes across the upper portion of the implant and causes it to assume a teardrop shape. Most patients have enough natural breast tissue to camouflage the implants quite nicely.
ADVANTAGES OF ANATOMICAL BREAST IMPLANTS
The lack of fullness in the upper portion may be helpful for patients who have minimal breast tissue, such as athletes and breast reconstruction patients. These implants seem to have less rippling and irregularity than standard implants, which can be an important consideration in patients who have little of their own breast tissue to camouflage the implants.
DISADVANTAGES OF ANATOMICAL BREAST IMPLANTS
In general, anatomical breast implants are firmer than standard round implants. Anatomical breast implants are more expensive than standard breast implants. If an anatomical implant rotates out of its proper position, it may be necessary to reposition the implant, which means another surgery. In general, anatomical breast implants are “fussier” and require more technical skill on the part of the surgeon than standard breast implants.
We Can Help You Decide if Form Stable Implants Are Right for You
During your consultation, we will perform a detailed analysis of your breast structure and relate this to your goals for breast surgery. With more than 20 years of experience in breast surgery, we are in a good position to advise you whether anatomical implants will benefit you. Call us today at 312-751-2112 in Chicago, or 847-446-7562 in Winnetka. Dr. Cook and his team proudly welcome patients from throughout Gold Coast and the Northern suburbs of Chicago.
Seeing Is Believing
Browse before and after photographs of Dr. John Q. Cook’s Chicago breast surgery patients.