Intraoperative Comparison of Anatomical versus Round Implants in Breast Augmentation: A Randomized Controlled Trial

Area of Science:

• Plastic Surgery
• Aesthetic Surgery
• Biomaterials

Background:

• Breast augmentation is a common cosmetic procedure.
• Implant shape (round vs. anatomical) is a key consideration for aesthetic outcomes.
• Patient and surgeon preferences influence implant selection.

Purpose of the Study:

• To compare the aesthetic outcomes of anatomical versus round silicone implants in breast augmentation.
• To determine if anatomical implants offer superior aesthetics compared to round implants.

Main Methods:

• A randomized controlled trial involving 75 patients undergoing primary breast augmentation.
• Each patient received both a round and an anatomical silicone implant (one per breast), with the anatomical implant replaced by a round one post-evaluation.
• Aesthetic evaluation by 10 plastic surgeons and 10 lay reviewers using blinded assessment of intraoperative photographs.

Main Results:

• No significant aesthetic difference was observed between anatomical and round implants by either plastic surgeons (43.6%) or lay individuals (29.2%).
• When differences were perceived, preferences for anatomical or round implants were not statistically significant (p = 0.496 for surgeons, p = 0.140 for lay individuals).
• Plastic surgeons could correctly identify implant shape in only 26.5% of cases, indicating poor detectability of shape differences.

Conclusions:

• This study provides high-level evidence that anatomical implants are not aesthetically superior to round implants in breast augmentation.
• The lack of proven aesthetic advantage, coupled with unique disadvantages of anatomical implants, suggests they should not be favored for routine use.
• Further research may be needed to explore specific patient populations or outcomes where anatomical implants might offer benefits.