Anatomic or “teardrop” shaped implants were created with a more natural shape in mind and designed to be fuller at the lower half similar to a natural breast. However, this distinct vertical orientation can result in distortion or breast asymmetry if the implant should rotate. A textured surface allowing tissue in-growth helps reduce the chance of rotation however may result in more visible or palpable rippling. Anatomic implants are not commonly used for these reasons.

Most plastic surgeons routinely use the most common, round implant. Since the breast implant is round, it is free to rotate without any adverse consequences. With gravity alone the saline or cohesive rtv silicone gel will gravitate or fill the bottom portion of the implant when sitting or standing erect or fill the breast more uniformly when lying down supine, more closely imitating a natural breast.

Three distinct profiles also exist ranging from moderate profile to moderate plus/mid range to high profile. The moderate profile implant has a wider diameter with the least forward projection whereas the high profile breast implant has a narrower base diameter and the most forward projection. The moderate plus/mid range profile has, for most, the best in diameter and projection. Your plastic surgeon, in his or her comprehensive physical examination will help you choose the most appropriate size, shape and profile implant best suited for you.

The surface texture of the breast implant may also vary from smooth to one of a variety of textured or rough surfaces. Textured breast implants were originally designed to reduce capsular contracture (firmness and hardening of the tissue which heals around the implant). The textured surface allows tissue in-growth which fixes or adheres the breast implant to the surrounding tissues in a steady position. Since the tissues adhere to the breast implant, it is more likely to feel the ripples or waves which are natural in any implant. The smooth breast implant however does not adhere to any tissues and is free to move inside the implant “pocket.” With a proper size implant and the proper creation of the breast implant “pocket,” there is less chance of feeling and seeing the breast implants and a more natural feel and movement of the breast. There are certain possible advantages and disadvantages to each type of surface. Unless otherwise indicated, many cosmetic surgeons will use smooth round implants.

The implant may be placed above the chest muscle (pectoralis muscle) or under the chest muscle. Plastic surgeons generally place the implant under the chest muscle. Reasons for sub-muscular placement include a lower rate of capsular contracture (firmness and hardening of the healing tissues around the implant) and a more natural result due to more soft tissue coverage over the implant. Placement of the breast implant beneath the muscle may produce some movement and/or distortion of the breast and implant with active movement or exercise of the chest muscle, arms and shoulders.