Why I Am Not A Fan Of Shaped Breast Implants
-Win Pound, M.D.
Breast implants come in many shapes, sizes, and styles. In fact, the more options there are, the more confusing it sometimes becomes as to which one to use. Most plastic surgeons have their own personal favorites that they use based on their training and experience. Lately, there has been a lot of attention paid to using shaped breast implants for breast augmentation surgery. While these may work well and give good results in the right hands, I am not a big fan of these shaped implants for several reasons:
Shaped implants are more expensive than round breast implants.
If you take a round breast implant and hold it upright, it assumes the same shape as a shaped breast implant. The chest muscle and gravity also help mold the shape of the implant once it is in place. With that in mind, I find it hard to justify the extra expense of a shaped implant.
Shaped breast implants must be very precisely positioned. There is actually a mark on the shaped implants denoting the midline which needs to be lined up with the midline of the breast itself. If this is not done, the shape of the breast may be affected. Round implants do not need to be so precisely oriented. They can turn or even flip over with no consequences to breast shape.
Shaped breast implants have a textured surface. In the past, putting a textured surface on an implant was for the purpose of minimizing the formation of capsular contractures (scar tissue capsules that can form around a breast implant causing the breast to feel firm or distort the way it looks). While this may be beneficial when implants are placed above the chest muscle, statistically, it makes no difference if the implant is below the chest muscle. With shaped implants, the textured surface is designed to help hold the implants in position and decrease the risk of having them shift or turn. Adding a textured surface can make an implant stiffer, however, which may cause ripples and wrinkles to be more palpable. I also believe that it may shorten the lifespan of the implant as compared to a smooth surface implant.
Breast augmentation surgery is more difficult to perform with a shaped breast implant. The pocket developed to hold the implant must be very tight so as to minimize the chance of implant shift. Also, a larger incision is required in order to accommodate the textured surface implant. Finally, these implants cannot be inserted through an incision under the areola, again, because a longer incision is required.
While I have no argument with doctors who feel comfortable using shaped breast implants, it is not my favorite implant to use in most cases.