Breast Implant Shapes & Profiles

Implants come in basically two shapes, round and anatomical. The anatomical implants are also known as teardrop implants. Currently, saline implants are available in round and anatomical, whereas silicone gel filled implants are available in only a round shape.

Round vs. Anatomical

So which gives a more natural shape, round or anatomic? With regard to saline implants, I strongly believe that an anatomic implant gives a more natural look. Most of my patients who want a round implant, when asked why, state “I want that extra fullness on top.” The fact is, that if you take (I have done this and even photographed it for evidence) a saline round and an anatomical implant, fill it to the manufacturer’s specification and place them on their sides in the palm of your hand, which will simulate how they sit within the breast in an upright person, you will see more upper pole collapse in the round implant than the anatomic. This is due to the difference between the biomechanical forces within each implant.

The reason that some women think that a round implant gives you more upper pole breast fullness is threefold: an implant larger than desirable for that person’s tissue may have been selected and that person was over augmented, the implant was overfilled making it tense which will retain upper pole fullness at the expense of implant shape distortion and lastly the person’s tissue envelope may have been tight to begin with, which will have more upper pole fullness than a lax tissue envelope (see the previous discussion about type I vs. type II breast types). I have a very definite opinion here: I strongly believe that an anatomical saline implant will produce a more natural result than a round saline implant. If one looks critically at the saline implant cases on my photo gallery, I believe that they will come to the same conclusion.

Comparison of three augmentations performed using round saline, anatomic saline and round silicone gel implants (all placed under the muscle):

In the case of silicone implants, I think that the coherent nature of silicone gel changes things. Silicone gel implants are less firm than saline implants, so the breast tends to retain its natural shape tendency, rather than have it influenced by the firmness of a saline implant. There are anatomical silicone gel implants called form stable implants, the “Allergan 410″ implants which are currently in FDA trials and hopefully will be available in this country soon.

Implant “Profiles”

Round silicone gel filled implants come in four “profiles” as demonstrated below. For a given volume of implant, a low profile has a wider base width but less forward projection, a high profile has a narrower base width but a greater forward projection, and a medium profile lies in between the two.

Natrelle is Allergan’s brand of silicone gel filled implants. The top row is the style number for ordering purposes, the middle row is Allergan’s name for the profile shape, the bottom is my assessment of the profile, probably the easiest way to remember them.

Natrelle Style 10	Natrelle Style 15	Natrelle Style 20	Natrelle Style 45
"Moderate profile"	"Moderate-plus profile"	"High profile"	"Extra high profile"
Low profile	Medium profile	High profile	Very high profile

When selecting an implant profile, one must take into account the tissue envelope. Trying to achieve more forward projection with a high profile implant in a tight tissue envelope will not work because a tight envelope will simply limit the amount of forward projection that you can have and will furthermore probably result in atrophy of breast tissue and possibly even a chest wall deformity (depression in contour). An important point to remember is that probably all breast implants will result in some atrophy of the breast tissue, so it is paramount to choose an implant size and profile to minimize this deleterious effect upon the breast tissue. The solution is to go with a lower profile implant. My personal opinion and recommendation, for the vast majority of cases, use either low or medium profile to avoid damage to the breast tissue in terms of atrophy.

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