Breast Implants – Picking the Right One-Part 3

Womans breasts in black bra

I hope you’ve had a chance to read the first 2 installments of this breast implant series.  If not, it would be very helpful to start from the beginning (Part One) and catch up on the basics of implant types, sizes, and profiles before moving on to your implant shape choices.

Implants Come in Different Shapes?

Traditionally, breast implants have been “round” in shape.  Let me clarify this.  A round implant is not shaped like a ball.  It is flat on the back side (the side that sits against a woman’s rib cage) but round in that it’s equally tall and wide.  How far it sticks out from the rib cage is referred to as its “projection,” which was discussed in part 2 of this series (Part 2).

For many years, round implants were the only option available in the US, so most women in our country have round implants.  Virtually all of the saline implants available are round, so for the remainder of this discussion, assume that we’re referring to silicone implants.  In 2012, the FDA approved a shaped implant, though they had been available elsewhere in the world for a long time.  These are referred to by several names including shaped silicone, anatomic, tear drop, and gummy bear (no, they’re not shaped like candy, but the name will make sense in a minute).

Round versus Shaped Implants

In order to understand some of the pros and cons of the round and shaped silicone implants, we need to start by talking about the silicone gel that fills them.  There have been several versions of silicone gel used in implants over the past 5 decades.  Early silicone implants had gel that was liquidy, while the implants we use these days contain a gel that’s referred to as “cohesive.”  This means that it is thicker in its consistency, sticks to itself, and basically is more solid than liquid.  The more “highly cohesive” a gel is, the more solid it is.

Round silicone implants in general contain a cohesive silicone that has a texture I like to describe as a cross between Jell-O and honey.  It’s kind of a solid, kind of a liquid, gooey, and sticky.  This results in an implant that is soft and squishy like the texture of most women’s breasts, which makes these implants feel pretty natural in most cases.

Shaped silicone implants typically contain a silicone gel that is more highly cohesive than the round implants.  This more highly cohesive gel has a consistency that’s more solid than liquid, so if we cut a shaped implant in half, the gel it contains won’t really ooze out of its shell and it mostly stays in two pieces.  Just as a gummy bear candy doesn’t lose its filling and deflate when you cut it in half, these implants won’t either, which is how they got their colorful nickname!  Because the gel that fills them is firmer, the feel of these implants tends to be a little firmer as well.  I’ve had patients who tell me their shaped implants feel like “18 year-old breasts.”  Technically these implants can still rupture like any implant can, but in my experience the silicone stays more contained when they do and the surgery to replace them is a bit easier.

You may be wondering what “shape” these shaped silicone implants have.  Basically they’re still flat on the back side but they have more fullness at the bottom, less fullness at the top, can be wider than tall if desired, and also have different options for projection (i.e. some stick out from the rib cage more than others – this is similar to round implants).  The fact that these implants are filled with the more highly cohesive silicone gel allows them to maintain this shape when implanted in the body.  The theoretical benefit of a shaped implant is that it provides a more natural-appearing shape, since real breasts have more fullness at the bottom than the top.  This theoretical benefit is more apparent in some women than others.  I find it to be especially true in women having breast reconstruction after mastectomy; women with flat, poorly-defined breasts; and women with tubular breasts (This is a breast shape that I won’t go into details about here.  Most women don’t have this type of breast.).

How to Decide

Some women prefer the feel of one implant over the other.

Women who choose round implants may do so because:

  • Their friends have round and that’s the type with which they’re more familiar.
  • They want or need more fullness in the upper breast.
  • They want more cleavage on occasion with the use of a push-up bra (without a bra the cleavage with a round and shaped implant is usually similar)
  • They want a higher-profile implant with a more “augmented” or fake look (but I say this with the caveat that a round implant can look very natural depending on the volume and profile chosen).

Women who choose shaped implants may do so because:

  • They want a more natural look with less upper breast fullness.
  • They feel more comfortable with the idea that the silicone doesn’t leak out as much if the implant were to rupture.
  • There’s a slightly lower risk of capsular contracture (overgrowth of scar tissue around the implant) with these implants compared to the round type.


Well, if you’ve read the whole 3 part series, you are now well versed in the choices women have in choosing their breast implants.  If you’re considering breast augmentation, hopefully this will help you feel more comfortable with the process.  If you’re not in the market for “new” breasts, you at least have plenty of information for cocktail party conversation (believe me, people like to talk about this stuff)!

Although we intended for this to be a 3 part series, there is an exciting new implant option that will be reviewed in a supplement to this series, Stay tuned!

To continue reading the next installment of Breast Implants-Picking the Right One, click here.

If you are interested in scheduling your consultation with Dr. Peters, please call us at 708-524-1400 or fill out our contact form today.

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