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How Do I Choose a Breast Implant Shape?

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There aren’t that many options when we talk about the shape of breast implants. Most people are deciding between a more natural teardrop-shaped breast and a less natural-appearing rounder breast shape, and if this is a matter of personal preference some people want to look naturally busty, and other people want to look like they had surgery.

Here we’re going to go through some of the factors that can impact the ultimate shape of your breast augmentation.

First, we’ll talk about the more natural-appearing teardrop shape breast. This breast shape is characterized by a nice gently sloping upper pole with a round proportionate lower pole. The upper pole of the breast is the portion of the breast that is above the nipple-areolar complex, and the lower pole of the breast is the portion of the breast that is below the nipple-areolar complex.

The other general shape of a breast implant or breast augmentation is the round of breast, and this is characterized by a more even distribution volume between the upper and lower pole of the breast or what we might call a breast with a great deal of upper pole fullness.

3 factors will determine the shape of your breasts after the breast augmentation procedure.

The first is the shape of the breast implants themselves. The second is the size of the breast implants, and finally, the third factor is the position of the breast implants, specifically whether it’s placed above or below the pectoralis major muscle.

In terms of the options with regards to the shape of a breast implant itself, there are 2 choices.

The first is around the breast implant. Around breast implants has an even distribution of its volume such that it looks like an oval when viewed from the side, that is, there is an equal amount of volume that goes into the upper pole of the breast and that goes into the lower pole of the breast.

The other option for the shape of a breast implant is what’s called an anatomic breast implant also called shaped breast implant, and when we look at a shaped anatomic breast implant from the side will notice that there is a relative fullness of the lower pole of the implant and a relative lack of volume at the upper pole of the breast implants.

Round breast implants were the original type of breast implant and the teardrop or anatomic shape breast implant came along a bit later to help surgeons achieve a more natural or teardrop-shaped breast.

One thing that’s important to know about teardrop-shaped breast implants is that once they are placed in the implant pocket they can change positions over time, whereas this is not an issue with round breast implants. While around breast implant might rotate over time it just doesn’t matter because it has an even volume distribution.

On the other hand, if a teardrop-shaped breast implant rotates every time, that can lead to an unnatural on your regular breast shape because the implant has an uneven volume distribution, so to minimize the chances of shaped breast implants rotating after it is placed, one of the things that the breast implant manufacturers did was introduce texture to the shell of the breast implants so this is just a very rough surface and the idea is that it adheres to surrounding tissue and minimizes the movement of the breast implant after it is placed.

With the recent discussions of ALCL or anaplastic large cell lymphoma which is an extremely rare form of malignancy associated with textured breast implants, surgeons are not using textured breast implants at this point, and therefore they aren’t using these teardrop-shaped breast implants, so they are sticking to round smooth breast implants and at this point as there have not been any cases of  ALCL reported in association with smooth or non-textured breast implants.

The choice of the shape of the breast implant is dramatically simplified because there is the only one that most people are using which is the smooth round breast implant.

The next factor that contributes to the shape of your breast augmentation is the size of the breast implant.

If you put a very large breast implant into someone with a relatively small frame it’s going to be more visible and it will have more visible upper pole fullness so the breast augmentation will look less natural.

If you use a smaller volume breast implant you are going to have less visible upper pole fullness and you’ll tend to have a more natural-appearing result. The size of your breast implant is something that you’ll decide with your board-certified plastic surgeon at the time of your consultation to find a breast implant size that fits your body size and shape and as such that it can deliver the look that you’re going for.

The next thing that specialists consider with regards to the appearance of your breast augmentation or the shape of your breast augmentation is where your implant is placed concerning the pectoralis major muscle.

The pectoralis major muscle is one of the muscles of the chest, and it is positioned underneath the breast tissue or the breast gland, and surgeons can either put a breast implant over the muscle or under the muscle.

In cases where they are looking to achieve a more natural appearance, they are going to tend to put the breast implant under the pectoralis major muscle because that simply camouflages the implant more effectively as there is more tissue between the implants and the outside world, specifically if you put an implant under the pectoralis major muscle the layers going from inside to outside the breast implant, pectoralis major muscle, breast gland, fat, and then skin.

On the other hand, if you put a breast implant over the pectoralis major muscle you are more likely to see that implant, and you are more likely to see a more pronounced upper pole, so in that case, you are putting the implant over the pectoralis major muscle and the layers moving from inside to outside, in this case, are breast implant, breast tissue, fat, and skin. Since there’s less stuff between the breast implant and the outside world it is going to have a less natural appearance with more pronounced upper pole fullness.

Putting this all together, in terms of deciding about your breast implants shape and how you are going to get the shape of the breast augmentation that you want if you are going for teardrop-shaped breast augmentation since surgeons are not using the teardrop breast implants, or the anatomic or shaped breast implants, at this point the way to maximize a natural appearance, which they can do very effectively even without using teardrop breast plants, is to choose an implant that is of moderate size, not oversized with comparison to your size and shape and placing that implant under the pectoralis major muscle.  The key to all of this is to speak with your surgeon and make your preferences known so that in your search you can come up with a plan together.

Do breast implants change shape?

Yes. There is one kind of shape change that all breast implants undergo, and it’s a natural and expected part of a breast augmentation procedure, and this is the breast implant drop. This means it means that when surgeons place your breast implant, right after the procedure it’s going to look like it is relatively high up on the chest wall and there is going to be exaggerated upper pole fullness.

Over time your chest tissues are going to relax, and the breast implant is going to gently settle into its final position, and that exaggerated upper pole fullness will tend to fade away unless you made an effort to preserve that upper pole fullness by either choosing a very large breast implant or putting the implants over the pectoralis major muscle. The breast implant drop refers to the normal process of a breast implant settling into its natural shape and position over time and this is something that usually occurs within a few weeks to a few months after the procedure and it is very variable from person to person and it is pretty difficult to predict the timing of the breast implant drop.

The other thing that can cause a breast implant to change shape is breast implant rupture. If you have saline breast implants and it pops or ruptures due to either trauma or fatigue, over time the whole thing will just deflate like a water balloon and the affected breast will lose volume, essentially flatten out too close to its original volume, and there won’t be any question about what happened, you’ll be able to tell just by looking yourself in the mirror that your breast implant ruptured. 

On the other hand, the silicone breast implant may not deflate if it ruptures, and often that modern silicone gel breast implant won’t simply because they’re made out of a highly cohesive silicone gel such that a lot of these implants, especially what surgeons refer to as a gummy bear implant because of their consistency, can be cut in half and the gel more or less stays put, so it is for this reason that when you have a silicone at gel breast augmentation the FDA recommends that you have periodic MRI after the procedure to ensure that your breast implant has remained intact, and this is where the term silent rupture comes around, since with a silicone breast implant your implant can rupture and you may never know because the shape may not change, whereas on the other hand, with a saline breast implant, if that ruptures you are going to know right away because the saline will just leak out.

The other way that a breast implant can change is with capsular contracture.

Capsular contracture is an uncommon complication of breast augmentation, and what happens in capsular contracture is that the scar that forms around the breast implant, and every implant will form a scar, and that is how the body walls off the implant and keeps it safe.

The abnormal thing that occurs in capsular contracture is that the scar around the breast implant, which surgeons call a capsule, actually shrinks.

If you can imagine a scar, a spherical car at shrinking around a ball, in this case, the breast implant that has a fixed volume that can, first of all, be painful, and second of all this can change the size and shape of the breast implants. With the capsular contracture, the implants often need to be removed and replaced and there are several ways to deal with this. The capsular contracture is another way that a breast implant can change shape.

Another way a breast implant can change shape is what was alluded to earlier, and this is when an anatomical or teardrop breast implant rotates, this can also lead to abnormal or asymmetric breast shape. 

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