The concept of an anatiomically shaped breast implant is not new and dates back for over a decade. Simplistically, it is an implant where the retaining shell has a shape that allows more implant volume to be in the lower half than in the upper half. The inexact ratio is about 2/3s volume lower half and 1/3 third volume upper half. This volume distribution remains the same whether the patient is standing or laying down. This shaped implant has become known as a teardrop geometry and is associated with having a more natural look than a round breast implant by virtue of less upper pole fullness.
Besides the shape, there are several unique features of an anatomic implant. For cosmetic breast augmentation it is only available in silicone gel and not a saline fill. It is also only available in a textured and not a smooth implant surface. This is because it is critically important that the implant does not move in the pocket, otherwise it will create an odd shape to the externally viewed breast. The textured implant surface allows the surrounding tissues to grab onto and create tissue adhesion, this not allowing the implant to move. This is unlike a smooth round implant which can roll around in the pocket like a ball bearing and not cause any adverse change in the external breast shape.
The textured surface of the anatomic breast implant causes two important and necessary modifications (restrictions) in its surgical placement. First, it can only be placed through an inframammary or lower breast fold incision. It has to be placed so that it is correctly oriented and this must be visually seen. Secondly, the implant pocket, specifically the inferior or lower end of the pocket must be made and the implant placed in exactly the final implant position that one desires. Textured implants will not drop due to the tissue adhesion and, even if they do, it will take much longer than with smooth round implants.
Another feature, and one that is often confusing to patients, is that of the geometry of the textured shape breast implant base. They are available in either circular, oblong or oval base shapes. These differing implant shapes are designed to be used for the three different body types, ectomorph, mesomorph and endomorph, which have been shown by studies done long ago that the shape of the breast base largely follows the shape of the torso. This means that a mesomorph or athletic torso needs a round implant base, an ectomorph or asthenic torso needs an oval (vertical elliptical shape) implant base and an endomorph or pyknic torso needs an oblong (horizontal elliptical base) implant base.
Textured silicone gel breast implants are a very useful device option in the breast augmentation patient and have largely been underutilized until recent times. Part of reason has been the limited availability of anatomic implant shapes unlike the rest of the world where they are more widely used and has been available for a much longer period of time. The other reason is the near complete unawareness by patients and plastic surgeon unfamiliarity with their potential benefits.
Dr. Barry Eppley