How Do I Choose a Breast Implant Shape?

Does the shape of a breast implant determine the final breast shape? It is one factor among several. Darren M. Smith, MD, a board-certified plastic surgeon in New York City, explains how implant shape, size relative to the body and placement interact with a patient's preferred appearance.

Originally published September 4, 2020. Implant availability, practice preferences and safety statements in this recording reflect that time; current context appears below.

Key takeaways

🎯 Breast shape preferences

The episode distinguishes a gently sloping upper breast from a fuller upper pole. These are aesthetic preferences to discuss, not a single ideal everyone should share.

🔎 Implant shape options

Round and anatomically shaped implants distribute volume differently. Rotation of an anatomical implant can change its appearance.

📏 Implant size and coverage

Implant size and tissue coverage affect how prominent an implant looks; the implant's label alone does not predict the result.

📅 Historical implant preference

Dr. Smith describes his preference in 2020 for smooth, round implants and explains how he approached different aesthetic goals with them.

🔄 Healing and implant changes

Breasts can change during healing, but rupture, capsular contracture or implant movement can also change appearance and require evaluation.

🎧 Episode guide

00:00 — Introduction

02:02 — Shape, size and placement

03:47 — Rotation, texture and the 2020 safety discussion

05:47 — Implant size and tissue coverage

09:20 — Settling during recovery

10:34 — Rupture and other causes of shape change

💬 Common questions

Can round implants produce a sloping upper breast?

Dr. Smith explains that they can in an appropriately planned augmentation. The discussion centers on selecting dimensions and placement in relation to the patient's body and goals rather than assuming that only a teardrop implant can create that look.

Do implants change position after surgery?

The episode describes gradual settling during healing and notes that its timing varies. It also distinguishes settling from complications that can change shape. New or concerning changes should be assessed rather than automatically attributed to normal settling.

ℹ️ Current implant safety context

The FDA states that BIA-ALCL risk is higher with textured than smooth implants. The recording's absolute statement about smooth implants should not be taken as a current zero-risk assurance. Implant-specific risks and alternatives belong in an informed consultation.

For silicone implants, current FDA guidance on rupture recognizes ultrasound as an alternative to MRI for screening patients without symptoms. Confirm a follow-up plan for your implant; the original MRI discussion is not a complete current monitoring plan.

🔗 Related information

Read current information about breast implant options, breast augmentation, and augmentation recovery, or schedule a consultation.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Educational information, not individualized medical advice. Implants are not lifetime devices, and results and risks vary. Show notes updated September 30, 2026.

Full transcript and related resources