September 26, 2016
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Anatomical, round implants found aesthetically comparable in breast augmentation

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LOS ANGELES — There was no aesthetic superiority in anatomical implants compared with round implants in breast augmentation, according to research presented at Plastic Surgery The Meeting.

“There’s no advantage to using anatomical implants in breast augmentation given their considerable disadvantages compared with round implants,” David A. Hidalgo, MD, clinical professor of surgery, Weill-Cornell Medical College, told Healio.com/Aesthetics.

David A. Hidalgo, MD

David A. Hidalgo

Hidalgo and Andrew L. Weinstein, MD, conducted a level 1 randomized control trial, in which they implanted one round and one anatomical implant in each breast of 75 patients undergoing augmentation who had not previously had implants. Multiple view photographs were taken with the patient sitting fully upright. The anatomical implant was then removed and replaced with a round implant, and the procedure was completed.

Twenty-five cases each represented Allergan, Mentor and Sientra implants, with an anatomical implant model that provided the best shape and identical volume to the round side.

Ten plastic surgeons and 10 lay reviewers responded to an online survey showing the implant results, with all reviewers asked, “which breast was more aesthetically pleasing,” and “by how much” using a 5-point Likert scale. Plastic surgeons also were asked which implant style they thought was placed on the side that they thought was a better result.

The average implant size was 278 cc for both types, Weinstein said.

In 36.4% of the cases, no observable difference was noted between the anatomical and round implants. Neither reviewer group preferred the anatomical side significantly more often than the side with the round implant. There also was no aesthetic preference with the manufacturer.

In 35% of cases the plastic surgeon reviewers reported not knowing which implant shape was producing aesthetic superiority, while in the cases where they reported they believed they knew the implant type, the reviewers were only able to correctly identify it 27% of the time.

“Given disadvantages including greater firmness, malrotation potential, possible higher risk of late seroma and [anaplastic large cell lymphoma] due to surface texturization, limited incision options and greater costs, a lack of proven aesthetic superiority argues against the continued routine use of anatomical implants in breast augmentation,” the researchers wrote. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.

Reference:

Hidalgo DA, et al. Intraoperative Comparison of Round vs. Anatomical Implants in Primary Breast Augmentation. Presented at: Plastic Surgery The Meeting; Sept. 23-27, 2016; Los Angeles.