When to Use Form-Stable (Anatomic) Implants
Determining the Right Body Type and Breast Shape
Most breast augmentation patients will get a nice result from round, smooth surface implants, but there are specific cases where a shaped implant works better. These implants go by many names – anatomic, shaped, teardrop, cohesive, gummy bear – but the preferred term is “form-stable.” These implants are firm enough to hold specific shapes that don’t change with position; sometimes an advantage, sometimes not. I recommend an oval-base teardrop profile implant in breasts with a specific shape: wide set and with a short nipple to fold distance.
Here is an example of a patient that had form-stable, oval base implants (Sientra 370 cc high profile.) On the VECTRA 3D analysis, you can see that the patient’s breasts have a wide distance between them, and the distance from the nipple to the bottom edge of the breast is short (the bottom edge, or inframammary fold, is the purple line.) This type of breast has an oval base, not a round one. If round implants are placed without lowering the fold, the implants will not be wide enough to make the breasts appear closer together, and the nipples will look too low on the breasts. Larger round implants will have to go lower than the fold, possibly creating a double bubble, or they will sit too high making the nipples appear even lower. Oval base form-stable implants are designed with the maximum projection closer to the bottom, but because they are wider, they can fill out the breasts closer to the middle.
This patient desired implants in the 370 cc range, so the Sientra high profile was selected. This implant is 12.5 cm wide, 10.9 cm tall, and has a projection of 5.3 cm. Because these dimensions correspond well to the patient’s pre-existing anatomy, the early post-op result actually looks like a round breast, more natural than round implants could.
Because of the firmness and off-round shape, form-stable implants have a textured surface. This is intended to prevent implant rotation. There are definite trade-offs and issues with textured implants that you need to be aware of and discuss with your plastic surgeon, specifically the small but definite risk of ALCL. But for the right patient, they may be worth considering.
(Update Summer 2020: Due to the concerns about a connection between certain types of texturing and ALCL, the use of some brands of textured implants has been suspended in the U.S. and other countries. we are only using smooth round implants for the time being.)