The number of women who are undergoing breast augmentation on an annual basis shows no sign of decreasing anytime soon. It is a popular body changing/improvement operation because it creates an instantaneous change with the insertion of a breast implant. The size of the implant plays an obvious major role in enlarging the breast and a wide variety of sizes in saline or silicone implants is available from all three U.S. manufacturers. But in addition to sizes, breast implants are also available today in various projections (profiles) and shapes.
Breast implant projections and shapes are confusing terms even though they are quite different. Projection refers to the relationship between the base (width) of the implant and its height. Every size (volume) of implants can have various projections conceptually thought of as low, medium or high, although the manufacturers use terms like moderate, moderate plus, high and even ultra high to describe projection. These are all round-shaped implants that differ in width:height ratios. Projection determines how much a breast implant sticks out from the chest and far it extends toward the side of the chest wall.
The shape of a breast implant is quite different from its projection. There are only two types of breast implant shapes available; round and tear-drop. A round breast implant is the most commonly used shape and has been around for decades. It looks round when laid on a flat surface even though it may not have this shape in a woman’s chest when standing up.
A shaped breast implant has one side fuller than the other, hence the tear drop or anatomic name, and is of more recent use in cosmetic breast augmentation. It maintains the same shape when it is laid on a flat surface or when it is implanted and the patient is standing upright.
What is the role of a shaped implant in contemporary breast augmentation? For the woman who does not want a round-looking breast after augmentation and desires a more ‘natural’ result, the shaped implant would be the preferred device. For the woman who desires a rounder breast shape, even one that looks like it has been implanted, then they should have a round shaped device used of a high projection style.
When selecting a shaped anatomic breast implant, there are several caveats with their use. They all have a textured surface to allow for tissue adhesion to prevent any rotation or shifting of the implant in the breast pocket. Unlike a round breast implant, movement of a shaped implant will result in external changes in the breast shape. Because of their textured surface and the importance of precise placement and vertical alignment of the implant in the breast pocket, an inframammary fold incision must be used. Also because of the textured implant surface, there will be little chance that the implant will drop significantly after surgery. This requires careful attention during surgery that the exact implant position wanted after surgery is achieved before incisional closure.
A tear-drop shaped breast implant is a good choice for those women that want the most natural breast augmentation result that is defined by more of the implant volume in the lower breast pole.
Dr. Barry Eppley
Indianapolis, Indiana