Background: In the evolution of breast augmentation, shaped breast implants offer a relatively new and exciting option. While round implants can certainly enlarge any breast, some women do not prefer the resultant rounded shape to the breast that may occur if they have fairly taut overlying skin. Even in loose breast skin, large implants can still give the breast that ‘augmented’ look.
By changing the shape of the implant shell to a teardrop form (2/3s lower half, 1/3 upper half), the augmented breast should not appear so round. While the exact shape of the external breast does not always follow exactly the shape of the implant underneath it, it does have a major influence on it. For those women that fear the rounded breast augmentation look, shaped implants offer the more likely outcome of a natural result
Case Study: This 38 year-old female desired breast implants as she had lost most of her breast volume after multiple pregnancies. She had a mild degree of breast sagging but the nipples were no lower than the level of the inframammary folds. She wanted to be a full D cup size afterwards.
Under general anesthesia, inframammary fold incisions were made 2 cms BELOW her existing folds. This was done with the knowledge that much of the volume increase in her breasts from the implants would come from lower pole expansion. To avoid having the resultant scar in a more visible position on the lower breast pole, the new lower fold position was predicted to be lower. A submuscular pocket was made and 550cc shaped silicone gel (gummy bear) implants were inserted using a no-hands technique with an insertion funnel. The implants were rotated so that their position had a good vertical orientation and was centered beneath the nipples. The implants were in a dual-plane pocket. Multiple layer closure was then done.
Her after surgery result showed a dramatic improvement in her breast size and shape. She never suffered any significant after surgery period of having ‘high’ implants that needed time to drop. The lower position of the implants remained consistent with where they were placed during surgery.
Shaped breast implants require close attention during surgery to their placement. Because of their textured surface and the resultant tissue adherence to them, they do not shift or drop much after surgery so it is important that they are placed low enough from the beginning. Besides providing a more natural breast shape, shaped breast implants work extremely well in cases of mild breast sagging as their lower pole volume helps fill out the sagging breast tissues.
Case Highlights:
1) Shaped breast implants offer a distribution of its internal volume so that more is in the bottom half than the upper half.
2) For those women that desire a more natural teardrop look for their augmentation, shaped breast implants offer protection against too much upper pole fullness or the rounded augmentation look.
3) Because of their shape and the necessity to prevent rotation and subsequent breast shape deformity, shaped implants have a textured surface and must be put in through an inframammary fold incision.
Dr. Barry Eppley
Indianapolis, Indiana