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Updated: Apr 26, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
1Westlake Village, Calif. From the Westlake Cosmetic Surgery Center.
This article explains how surgeons can use Sientra’s shaped implants in breast augmentation. It outlines a step-by-step approach to selecting and placing these implants based on patient anatomy. The author emphasizes the importance of precise measurements like base diameter and sternal notch to nipple distance. These metrics help choose the right implant size and shape. The study also describes surgical techniques to avoid complications like malrotation. The author argues that shaped implants offer more natural results than round implants. The article concludes that shaped implants can meet a wider range of patient needs. Surgeons are encouraged to adopt shaped implants after gaining experience with the outlined methods.
Area of Science:
Background:
Prior to 2012, surgeons in the U.S. had limited implant options for breast augmentation. Round silicone gel implants were available since 2006, but they did not offer the same shape variability as shaped implants. Shaped implants had been used in other regions but were not widely adopted in the U.S. until Sientra’s approval in 2012. This approval introduced new possibilities for patient-specific outcomes. However, many surgeons remained unfamiliar with how to use shaped implants effectively. The lack of experience led to hesitation in incorporating these devices into routine practice. Surgeons needed guidance on implant selection and surgical techniques specific to shaped implants. The field lacked detailed algorithms for choosing and placing shaped implants. This gap motivated the development of a structured approach to using shaped implants in breast augmentation.
Purpose Of The Study:
This work aims to provide a practical framework for using Sientra’s shaped implants in breast augmentation. The author focuses on improving surgeon confidence with shaped implants through detailed surgical algorithms. The study addresses the challenge of matching implant shape to patient anatomy. It also clarifies how to measure and select implants based on patient-specific parameters. The goal is to reduce complications and improve outcomes in both primary and revision surgeries. The author emphasizes the importance of preoperative planning and implant selection. The study seeks to bridge the knowledge gap between implant availability and surgical application. By outlining step-by-step techniques, the author hopes to increase adoption of shaped implants in the U.S.
Main Methods:
The author draws on clinical experience with Sientra’s shaped implants to develop a surgical algorithm. The approach includes preoperative measurements such as base diameter and sternal notch to nipple distance. The author also considers tissue pinch and nipple to inframammary fold measurements. These metrics help determine implant size and shape compatibility. The study outlines ideal patient candidates for shaped implants based on anatomical features. Operative techniques focus on implant placement and handling to avoid complications. The author emphasizes the importance of implant height, volume, and projection in shaping outcomes. The methods combine patient-specific data with surgical best practices to guide implant selection.
Main Results:
The author identifies key anatomical measurements that influence implant selection. Base diameter and implant height are critical for achieving natural contours. The study shows that tissue pinch and sternal notch to nipple distance help predict implant fit. The author reports that shaped implants can better match patient anatomy than round implants. The algorithm reduces the risk of complications like malrotation and rippling. The study highlights the importance of implant projection in defining the final shape. Surgeons using the outlined techniques report improved patient satisfaction. The findings suggest that shaped implants offer greater versatility in outcome customization.
Conclusions:
The author concludes that shaped implants offer unique advantages for breast augmentation. The outlined surgical algorithm improves implant selection and placement accuracy. Experience with shaped implants leads to better patient outcomes and fewer complications. The study confirms that shaped implants can address diverse patient needs. Surgeons should consider shaped implants for patients with specific anatomical profiles. The author emphasizes the need for precise measurements and careful implant selection. The findings support the growing use of shaped implants in U.S. surgical practice. The approach described helps surgeons adapt shaped implants into their routine procedures.
Base diameter, sternal notch to nipple distance, and tissue pinch are key measurements for implant selection.
Shaped implants provide more natural contours and better match patient anatomy compared to round implants.
Implant height influences the final shape and symmetry, making it essential for achieving desired outcomes.
Precise implant placement and handling reduce risks like malrotation and rippling.
Patients with specific anatomical features like wide base diameter and low inframammary fold benefit most.
The author suggests that shaped implants will become more widely adopted as surgeons gain experience.