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
