Breast augmentation is the most popular plastic surgery treatment and has been for several years. When deciding to undergo this surgery, I discuss with my patients a few of the choices they need to make pre-operatively. In order of importance, the main choices to be made are:
- What size breast implant do you need?
- Where would you like the incision to be placed?
- Should you do saline or silicone implants?
As part of the first question of the size of the breast implant desired, I discuss with my patients the choice of shape of implant as well. One of the hallmarks of an unnatural-looking breast augmentation is the steepness of the angel of attachment where the breast meets the chest wall. Very large or poorly placed implants may look something like melons placed on top of the chest. To help mitigate this issue, shape or anatomical or "Gummy Bear" implants were first created several years ago. These implants are thinner at the top than the bottom.
While this shape may seem like a good solution to the 'melon problem', a recent research study presented to the 2016 American Society of Plastic Surgeons annual meeting found that shaped implants do not produce a more attractive augmentation result. Shaped implants also have a higher rate of post operative complication, including changes of position, which can lead to an asymmetrical, unnatural-looking breast. A round implant may also shift position, but because it is symmetrical, the external result is unaffected. Couple this with the increased technical difficulty of correctly placing the shaped implants, and I generally advise patients to stick with the smooth, round implants for nearly all cases of primary breast augmentation.
As you see in this recent before & after photo from a patient of mine, round implants can produce a very nature result. As a plastic surgeon, I must evaluate the patient's existing anatomy to determine where to place the implants in order to produce the most natural result possible. This result is a fantastic outcome for my patient: her breasts are symmetrical; we avoided the unnatural 'melon' looking issue; she has attractive-looking, natural cleavage; and the patient achieved the relatively large amount of augmentation that she desired.