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• W2741314502 abstract "Sir: It is necessary to clarify that, with the conclusion of this article,1 the authors are bending the truth. After reading this article,1 it seems like a bad dream, because we are leaving jurisprudence within our speciality, that the use of anatomical implants is indicated by marketing or just following a trend. I think that Dr. Carlos Rubi has to be very careful with the message he leaves in his article. I find the comparison between round and anatomical implants interesting. However, I think a better description of the type of patients would be appropriate because thin body habitus, breast deformities, breast asymmetries, and thorax deformities are some of the indications for anatomical implants. Another point to consider is the volume of breast tissue existing in the preoperative period, because the mammary gland is going to cover the implant and thus influence the result. For this reason, when the volume is very small or practically nonexistent, the final shape of the breast will be determined by the breast implant, and thus anatomical implants are indicated. However, if the breast volume is greater, it will cover the implant, and round implants are indicated. When the breast volume is moderate, the final shape will be similar to the original shape of the breast regardless of what type of implant is used.2,3 It would also be appropriate to take into account the age of the patients, in addition to their mammary and thoracic anatomy. The appearance that a patient wants to achieve is very subjective. Usually, patients aged 20 to 30 years prefer round implants and those older than 30 years will choose anatomical implants, seeking a more natural result. For example, anatomical devices may be preferred in patients who desire a natural appearance, whereas in patients desiring an “augmented” appearance or oversized breast, round implants may be more appropriate. The anatomical factors of the patients can have an impact on implant shape selection. We have to consider the breast shape, tissue cover, the constriction of the lower pole (tuberous breast), and breast asymmetries. Anatomical implants are favored by patients with thin tissue coverage (>1.5 cm). By contrast, in patients with good soft-tissue coverage, round implants may be used with excellent results. For all this, plastic surgeons should ask themselves what the shape of a beautiful breast is. Patrick Mallucci described the Venus de Milo as having perfect breast proportions.4,5 With respect to the rotation of anatomical implants, the percentage of rotation is much lower than that presented in the article from 5.2 to 14 percent and currently being 5 to 0.42 percent. The anatomical devices, despite being more expensive, have a lower incidence of fibrotic capsular contracture because of their greater cohesiveness. To conclude, I think that if the patient is thin and has severe mammary hypoplasia, this type of result would be totally different. The age and volume of preexisting breast tissue should have been specified. DISCLOSURE The author has no financial interest to declare in relation to the content of this communication. Javier Vera Cucchiaro, M.D.Private Clinic of Aesthetic and LaserAveniu Entre Rios 220Salta, Argentina[email protected]" @default.
• W2741314502 created "2017-08-08" @default.
• W2741314502 creator A5007904991 @default.
• W2741314502 date "2017-11-01" @default.
• W2741314502 modified "2023-09-25" @default.
• W2741314502 title "Comparing Round and Anatomically Shaped Implants in Augmentation Mammaplasty" @default.
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• W2741314502 doi "https://doi.org/10.1097/prs.0000000000003791" @default.
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