There are distinct
benefits and drawbacks to each shape of implant. Round implants allow the implant to rotate and move within
the breast pocket after the surgery.Anatomical implants require a more precise pocket to be
formed so that there is no rotation. Smooth,
round breast implants move more naturally than textured anatomic implants.
Round Implants are the most
commonly used shape for breast augmentation or breast reconstruction. Round
implants are available in both saline and silicone fillers. Round implants were
the very first implants ever used for breast augmentation and during the last 40
years the basic shape and design have not changed. Round implants do not have
the same complicated profile for symmetry and position as anatomically shaped
breast implants. Round implants are considerably less expensive than anatomical
implants.
Round implants are able to
move and shift in position without distorting the shape of the breast. These
implants are for the most part, less expensive than anatomical shape/contour
shape implants. Round implants are available in both smooth and textured
surface and also in the styles of
high profile,
moderate profile,
moderate plus
and
low profile.
Round implants are shaped like sphere.
Although it has been
stated that some people believe that round implants can give more of the fake
look versus the anatomical shape implants there are others who believe they can
also give a natural look. It has been stated that the anatomical implants do
have more of a natural shape compared to round implants, however; once the round
implant has been surgically placed inside the patient’s body in the pocket where
it will sit, by gravity alone, the round implant has the capacity of taking on a
natural look. This is because when a round implant is held vertically by the
edges into the position that it will take once inside the body, it naturally
takes on the look of a natural breast. There have been studies along with
x-rays to prove this point.
For those patients wanting
a rounder fuller look, with more upper pole fullness, round implants are a
perfect choice. Round implant can shift somewhat in side the pockets after
surgery yet still maintain the desired breast shape.
Anatomical implants are
also known by the name of ‘contour implants’. These were originally developed
specifically for breast reconstruction patients. This shape of implant has a
more “natural” look” compared side by side to a round shape, as it tends to have
more fullness near the bottom of the implant, with not as much upper pole
fullness. Anatomical implants come with a gentle slope at the top and more
fullness at the bottom. Because anatomical implants are tear-drop shape, they
tend to have an axis. This means the height and the width of the implant is
different than round implants.
Anatomical / Contour
Shaped Implant
It is critical that these
implants must be positioned very precisely and securely; any misplacement or
shifting of the implant could lead the breast to appear misshapen. Patients who
desire this “sloping” effect of anatomical implants should choose a surgeon who
has a solid track record with this type of implant.
Anatomical implants only
come in textured surface. This is because sometimes
teardrop shape implants can shift or
move. If an anatomical implant does this, because of the shape it is made in,
it will cause distortion of the implant in regards to the shape of the breast
and will cause asymmetry between the two breasts. It is very important that
these implants are placed correctly in the body to avoid any flipping or
shifting of the implant. The textured surface implant will adhere to the
capsule that is surrounding the implant, in hope of preventing any flipping.
There may
also prove to be a higher rate of fold failure in anatomical breast implants or
teardrop breast implants that may lead to
deflation.
Because these implants are
made in the textured surface, they tend to be a little bit firmer in touch than
smooth shell implants. Both Mentor and
Allergan make their newer cohesive
implants “Gummy Bears”
only in this shape at the present time. Silimed offers a "gummy bear" in a round shape implant, and the costs are
considerably more than regular round silicone or saline.
All the implant
manufacturers have a wide range of sizes and two types of textures
to achieve a variety of desired goals. The options for these
implants include both smooth and textured shell implants.
Textured Implants
were designed specifically to reduce the chance of
capsular contracture. Their mode of action is one that the
implant is given a chance to attach itself to the muscle/tissue
wall. The textured shell is much thicker than the traditional
smooth shell implant, to compensate for its rough surface. Because of the process that a textured implant must go through to
get its rough surface, it has been debated that these implants tend
to be more at risks for leaks and or
ruptures. There are
varying studies with whether or not textured implants actually do
help reduce the risk of
capsular contracture.
Textured
implants are much firmer to the touch than a smooth shell, and they
are known for causing traction rippling. Traction rippling happens when the implant
actually pulls on the tissue it is attached to causing an
indentation.
In the United
States, all
anatomical shape implants
come with a
textured surface so that it will prevent the implant from rotation
inside the pocket. With a round implant, if it should rotate,
there would be no visible distortion because of the fact that it is
round in shape. But with anatomical shape implants, they can
flip in the pockets causing great distortion. The textured
shell is supposed to aid with tissue adherence making rotation not
occur; however even with a textured surface, anatomical implants can
still have the ability to flip. The only way of fixing an
implant that has flipped would be by surgical intervention.
Implant
massage following Breast Augmentation surgery has been encouraged as a way to
prevent Capsular Contracture. It is more commonly practiced with smooth implants
because textured implants adhere to the surrounding tissue and are supposed to
decrease capsular contracture by this mechanism. While massaging textured
implants is not necessarily bad, it is counterproductive to the theory of the
implant adherence. If carried to
the extreme, one could encourage non-adherence and possibly a seroma
(fluid around the implant).
Having any kind or revision breast
augmentation surgery with removing a textured shell implant can be a
little harder than removing smooth shell implants.
Most patients should not lose
much tissue from having the textured implants however, sometimes
tiny pieces might be extracted with the implant upon
removal. Normally losing any tissue happens when you need to have a
capsulectomy. If the surgeon is
careful he will only remove the scar tissue - and even then, if your
surgeon is careful, will only remove the scar tissue.
Smooth Shell Implants
are much thinner than textured, and in fact thought of
being much stronger. Simply because of the fact that the
smooth shell implants do not have the imperfections that textured
implants have. You can however get rippling with smooth shell
implants.
All implants have
pros and cons attached to them, and in actuality there is no real
difference with what implant is superior to another. You will notice
as you go about your consultations, that each plastic surgeon will
recommend a certain type, shape and size for you. Each doctor
will have their own opinion with what implant will be best for you
with your anatomy.