Breast Augmentation: The Shape of Things to Come

Though it seemed that the evolution of the silicone gel breast implant stopped with the silicone implant moratorium in 1992, our office among others, continued clinical trials of implants we hoped will improve the outcome of breast reconstruction. Implants at the time of the moratorium came in a limited variety, round low to moderate profile implants, which do extremely well for augmentation of the breast. Augmentation is in essence enhancement of the natural breast size. Reconstruction of the breast where the breast shape and characteristics have been lost is a different matter. Our work has evolved in studies with the Allergan 153 implant, the Mentor Lumera, and now the Allergan 410, all of which are shaped implants which better mirror the natural breast shape and form. The shaped implants, also called teardrop have a tapered upper edge which can prevent a rounded look and mimic the natural breast profile. Instead of working with the implant diameter and projection alone, the shaped implants allow us to vary the height, width, and the projection independently.

As the new shaped form stable implants from Sientra have reached the market, and both Mentor and Allergan are in the process of FDA approval for their versions, we are likely to hear much more about them and how they will benefit breast augmentation. In our practice, we prefer an implant that is soft and fits and flows within the breast, moving and shifting in shape as the breast naturally moves. The best implant is one that does its job enhancing the breast in a way that cannot be seen or felt, out of mind. Smooth, round, moderate profile implants, either saline or gel will provide the need for most, and it is unlikely that stiffer shaped implants will have a broad appeal. Just our guess, however shaped implants will give us better control when we need it most. The very tight AA breast just might take on a better silhouette when compared to a round implant, and with breast asymmetry we might be able to keep the projection and dimension where we need it. Thin breast tissue and ripples? Again, the shaped implant may be a solution as it will show through less and ripple less than either saline or gel.

Though shaped breast implants will not take the place of current implants in breast augmentation, for those with special challenges, shaped implants will indeed be the shape of things to come.