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Breast Implant Comparison: Round vs Shaped

Factors Impacting Breast Augmentation Results

Woman running on beach to illustrate upper breast curve..

Does the shape of breast implants make a difference in the result of a breast augmentation?

There are many factors that impact the final look and shape of augmented breasts: original breast size, breast shape, thickness of tissue, elasticity of tissue, symmetry, rib contours, history of pregnancy, history of weight loss, etc. So how much of a difference does the shape of the breast implant make? This question can be a source of anxiety for many breast augmentation patients as they consider whether to get round implants or shaped ones.
Fortunately, a recent study in plastic surgery’s most prestigious journal, Plastic and Reconstructive Surgery, answers that question. Only silicone gel implants were studied, since they have a more natural feel and greater longevity than saline implants.

Difference between Round & Shaped Breast Implants

This shaped breast implant is fuller on the bottom that it is on the top, so that its point of maximal projection is off-center

This shaped breast implant has an off-center point of maximal projection.

Many plastic surgeons and patients alike assume that the shaped, sometimes called “anatomic” or “anatomically shaped,” implants look more natural than round implants. On the other hand, surgeons using round implants point to gravity as contributing to the final shape of round implants.

The main difference between shaped and round implants is where the “peak” is, or the point of maximal projection. That peak is off-center in the shaped implants, and it appears at a lower level when placed in the body. Ideally, that point of maximal projection lies behind the patient’s nipple.

That off-center peak sounds like a great idea, but if the implants turn, that peak can rotate into the upper part of the breast, distorting it. (Turning of the implant is called a “malrotation.”) A malrotation happens in up to 14% of patients. Of course, because it’s perfectly symmetric, rotation of a round implant has no effect on the shape of the breast.

Round breast implants: smooth silicone gel (left), saline (center), textured silicone gel (right)

Round breast implants: smooth silicone gel (left), saline (center), textured silicone gel (right)

There is another difference between round and shaped implants: cost. In the United States, shaped implants are about twice as expensive as round implants, which is a further disincentive for patients to request them for breast augmentation.

Of course, if shaped implants were to offer a better result, then the risk of malrotation and the cost of the implants would be worth it to many patients. So is there a difference in the look of the breasts with shaped versus round breast implants?

Is Breast Implant Shape Detectable?

To answer this question, the investigators compared smooth and round implants that were all 340 cc’s or less in volume. All breast implants were placed beneath the pectoralis major muscle (“submuscular” placement). Fifteen plastic surgeons and 15 nurses were asked to determine implant shape as they looked at before-and-after photographs of 15 women with round breast implants and 15 women with shaped breast implants.

Were they able to tell the difference? No. They were as accurate as if they had chosen by flipping a coin. The round and shaped breast implants were indistinguishable. The authors concluded:

“The use of anatomically shaped implants is not justified because, besides having a higher cost, there is a risk of malrotation with no benefit over round prostheses”.

This collection of breast implants shows the variety of shapes, sizes, fill (saline and silicone gel), and surface (smooth and textured).

This collection of breast implants shows the variety of shapes, sizes, fill (saline and silicone gel), and surface (smooth and textured).

The decision of what breast implant to choose before a breast augmentation can be difficult, but this article makes that choice just a little bit easier.

If you want to read the article, follow this link.

Choosing a board-certified plastic surgeon with good before-and-after breast augmentation results is the most important first step. The experienced surgeon listens to a patient’s goals and reviews what is and isn’t possible with a breast augmentation. The well-informed patient in the hands of an excellent surgeon is the best combination for a good outcome.

Dr. Heather Furnas

About Dr. Heather Furnas

Inspired by watching her plastic surgeon father operate in African bush hospitals, Dr. Heather Furnas followed in his footsteps, training at Stanford and serving on the Harvard clinical faculty. She and her husband, Dr. Paco Canales, practice together in Santa Rosa, California, where they raised their two children. (To learn more about their practice, visit She believes an informed patient is more likely to be a happy patient and is committed to providing that education. If you have any suggestions for topics you'd like to learn more about, she would love to hear from you!

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