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Which implants would you recommend, anatomical or round?


I am having breast augmentation next month. I am currently a 32A wanting to increase 2 cup sizes. So far my surgeon has recommended I have 215cc tear drop placed under the muscle however explained there is higher risk of rotation with my job (flight attendant). He said there are round ones that also have a natural look. Which would you advise is the best option to achieve a natural shape/look with my kind of job?


There are a number of things that go into selection breast implants. If your job as a flight attendant requires significant lifting and arm movement, I would try very hard to place the implant just under the breast tissue, not the muscle. This requires a textured implant, but you are already considering an anatomic implant which do not come smooth. I only use anatomic implants for very specific problems. In most people, even lack of superior fill of the breast (when there is at least 2 cm of pinch of breast tissue there) can be filled out with a round implant. Before deciding on an implant find out why the surgeon prefers under the muscle if you do, indeed, use your arms significantly and why he/she considered an anatomic implant. Though the indications are few, you could be one of those few.


Thank you for your question.  First a highly subjective and anecdotal concept is that it takes 150-200 cc of breast implant to increase breast size by 1 cup size in the bra you are currently wearing.  Thus if you want to increase your breast size by 2 cup was you may require an implant larger than 215 cc.

Second, there are so many advantages to placing the breast implant beneath the chest muscle that I prefer this approach whenever possible.  Placing the breast implant beneath the chest muscle provides better coverage, less risk of capsular contraction, and in many cases better mammographic visualization of the breast.

Finally shaped breast implants are more difficult place, and I agree with your surgeon that with your job displacement is a consideration.

In my experience round breast implants placed beneath the chest muscle give the most natural and optimal breast augmentation result.  Be aware that you will have some motion of the implant during your work duties however many patients who are very active including weight lifting have implants placed beneath the chest muscle without difficulty.


This is a common question plastic surgeons are asked because of the new anatomic implants and we are, in general, learning the best patients for these implants.

If you want to go up two sizes you will require larger implants.  You should try the rice test or Mentor test implants for sizing.  The discussion to place anatomic requires a photograph to look at your nipple position, skin laxity and the amount of skin below the nipple to the fold.

Round implant in the sub-muscular position has passed the test of time.  Good luck.


Shaped Implants



There is no "right" or "wrong" answer as to whether or not to choose round vs shaped implants. Its largely a matter of personal preference and the final result you wish to obtain. In my opinion, women who are small breasted get a greater benefit from the use of shaped implants. Smaller breasts tend to have less of a traditional breast "shape" and therefor tend to benefit more from the use of shaped implants. The larger the breasts are compared to the size of the implants, the less effect the shaped characteristic of the implant influences the final result.



Although it is true that shaped implants can rotate, if the surgery (creation of the breast implant pocket) is done well, the likelihood is small. In my observation, activity (job related or otherwise) plays a negligible role in the likelihood of the implant rotating provided that at least several weeks have elapsed after surgery prior to performing excessive arm use.


There are two aspects to your question: shaped vs round, and what size. Shaped implants are firmer, may require a longer incision for placement, and cost more. If your surgeon has recommended them based on an assessment of your anatomy and goals then it might be worth it. Round implants may move a bit more, as natural breasts do. Size is another matter, because there is no reliable formula to predict cup size based on implant size. An increase of 2 cup sizes seems likely to require more than 215 cc however.

Richard A. Baxter, M.D. - View Other Answers by this Doctor
Mountlake Terrace, WA

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