Part I

It’s not question that breast augmentation is one of the most commonly performed cosmetic enhancement surgeries in the United States. With this popularity in mind, there’s been plenty of discussion and comparison of breast implants, specifically the shape and aesthetics superiority.

Drs. Hidalgo and Weinstein from the division of plastic surgery at Weill Cornell Medical College in New York, published a study entitled, Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation. In this study, the doctors wanted to find out if there’s any “better” implant regarding aesthetic, especially when using anatomically shaped breast implants during breast augmentation.

Study Overview

For the study, they looked at any patient that had a submuscular breast augmentation through an inframammary incision along the breast crease. To control it, they excluded any patients who had a greater than 25-gram size difference, any nipple position or areolar diameter differences, any patient that had a breast lift in conjunction with breast augmentation, or any other breast or skeletal abnormalities or asymmetries.

Study Performance

After excluding some patients, they enrolled 75 patients with a standard submuscular dissection. During the study, they placed a round implant on one side and an anatomic sizer, with a smooth surface, or an implant with a textured surface on the other. Then, the doctors looked at photographs shown on paper, then the anatomic device was subsequently changed out to a round implant before the procedure was complete.

The doctors then surveyed 10 plastic surgeons, and 10 reviewers with no formal training (also called lay reviewers) on each patient’s pictures, asking which side was more aesthetically pleasing and by rating. They asked plastic surgeons specifically how the more aesthetically-pleasing breast was better, and if they knew what type of implant was on that side. Based on the surveys conducted, there was no observable difference in 36% and an observable difference in breast aesthetics in 64% of cases.

However, within the 64%, neither the plastic surgeons or lay reviewers preferred the anatomic side more. The surgeons picked the anatomic side better 51% of the time and round 49%. The individuals without prior experience picked the anatomic side better 47% and round at 53%. None of this data is deemed significant, and the aesthetically superior breast implant was also no more than moderately more pleasing compared to the other.

Characteristics of the “Ideal” Breast

None of the characteristics that they looked at for more aesthetically-pleasing, were chosen more frequently when the anatomic side was preferred after they corrected statistically. In 35% of cases, the plastic surgeons noted that they did not know what type of implant was on the side provided. Additionally, out of the plastic surgeons that thought they knew, they only correctly identified 27% of the time.

Anatomic Breast Implants Benefits

The study also went on to talk about how anatomic implants may be more aesthetically-pleasing for patients. It potentially gives patients a more natural appearance, especially thinner patients. Also, there is a better correction of sagging breasts, and there’s more implant choices. However, the doctors stressed that the data are mostly expert opinions, and not backed by scientific fact.

Downsides of Anatomic Breast Implants

In the study, they also discussed the downsides of anatomic implants, including firmness, limited incision choices, malrotation risks, the cost, and also texturing linking to later capsular contractures, seromas, and anaplastic large cell lymphoma (ALCL). However, they believe that texturing hasn’t actually been proven to reduce capsular contracture rate, especially in the sub-pectoral plane, that it’s not really worth using these devices until more information is provided about ALCL.

Many plastic surgeons and individuals have different criteria when it comes to shaped or round implants, and this is a very popular topic of discussion.

Stay tuned with our blog for more in-depth discussion about this study!

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Dr. Marvin Shienbaum is a double board-certified plastic surgeon who specializes in all forms of Cosmetic Surgery, including Breast Augmentation, Tummy Tuck, Liposuction, Brazilian Butt Lift, and Mommy Makeover. He serves patients in the entire Tampa Bay area, including Tampa, Riverview, Lakeland, and Brandon, Florida. For more information about your ideal aesthetic procedure, please visit