Round Versus Anatomical Implants in Breast Reconstruction: A Systematic Review and Meta-analysis

Implant-based breast reconstruction (IBBR) is the most commonly used technique for oncological breast reconstruction. Implants vary in size, composition, texture, and shape. Numerous studies have attempted to determine whether the postoperative outcomes differ based on the shape of the implant, the 2 most common being round and anatomical implants. This systematic review and comparative meta-analysis evaluates postoperative outcomes and aesthetic satisfaction following IBBR with round or anatomical implants.

A systematic review of the literature and comparative meta-analysis were performed to assess the differences in complication rates, patient-reported outcomes, and aesthetic satisfaction between patients undergoing IBBR with round or anatomical implants. Only comparative studies reporting on postoperative complications or patient-reported outcomes following IBBR were included. Odds ratios and 95% confidence intervals (95% CIs) were calculated using a random-effects model.

Nine studies were included, representing 2535 patients, with 1578 patients and 957 patients in the round and anatomical implant groups, respectively. No difference was observed in the overall complication rate between the round and anatomical implant groups (odds ratio = 0.46; 95% CI = 0.14-1.48; P = 0.19). Specific complication rates and patient-reported outcomes were also similar across groups.

In IBBR, round or anatomical implants have similar complication rates and aesthetic results. The choice of implant type should therefore be made through shared decision-making, guided by the surgeon's experience, the patient's morphology, and personal preference to achieve optimal results.