While anatomical or "shaped" implants can potentially lead to a more "natural" upper slope than with round implants, an appropriately sized (volume and projection) and placed (typically sub muscular) round implant can still have a natural slope. At 1 year it is likely that no further changes in "settling" will occur. You should follow up with your plastic surgeon to discuss your concerns.

Published on Jul 11, 2012

After one year, the pocket will not change to your advantage. In order to achieve the natural shape you want, unfortunately, you will have to undergo an additional surgery. In my experience, the difference between round and teardrop shapes are very small. In your case and cases such as yours, the problem lies in the dimensions of the pockets.

Published on Jul 11, 2012

When it comes to the difference between the anatomical shape and the round shape, it really depends on the profile of the implant and your own tissues. A moderate or moderate-plus style of round implant will look pretty natural, with a natural slope and fuller bottom. A high profile or ultra-high profile will provide a more rounded appearance. Over time, gravity can help settle things more with a round device. An anatomical Implant, because of its firmness and texturing, does not move much at all. I hope this helps.

Published on Jul 11, 2012

Teardrop/anatomic-shaped implants are a variant of silicone implants. The difference being a form-stable gel fill that imparts the anatomic shape. The "gummy bear" gel is the most cohesive/firm available. It is form stable and will hold a shape, thus the shaped/gummy bear. Additionally, these devices are textured as orientation is crucial (a teardrop is only a teardrop when oriented appropriately). The texture acts as a sort of velcro holding the implant in position.

In my practice, most patients will choose a smooth round device. When placed in the submuscular plane, the aesthetic differences are minimal. The downward pressure by the muscle across the upper pole of the round device forces it to assume a more teardrop appearance. Recent studies have shown that both patients and surgeons have difficulty distinguishing between the 2 implant types post-operatively. Additionally, shaped implants are more costly and have an increased risk of rotation.

With regards to your specific question, early results will change. At 1-year post-op, there is unlikely to be significant changes. I would encourage you to revisit your concerns with your surgeon. It is unclear what your specific concerns are, but there are likely options for revision.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012