Women coming to Rao Plastic Surgery interested in a breast augmentation will occasionally ask if “anatomical” (also known as “teardrop breast implants”) are right for them. Anatomical implants are implants that have a tear drop shape with more projection/fullness at the lower part of the implant, and the implant tapers at the superior portion of the breast. The thought behind the design of the anatomic implant was that the anatomic design mimicked the shape of the natural breast, which surgeons and patients thought would lead to a more natural result. As time has gone on we have learned that is not the case. Several studies have been conducted asking both plastic surgeons and regular people to look at a series of photos and try to identify which patients have had breast augmentation with an anatomic implant and which had a breast augmentation with a round implant. The results of the study showed that not only did regular people have a hard time identifying which implant was in which patient, but also plastic surgeons were unable to do better than the flip of a coin. A downside of using anatomic implants is the potential issue of implant malrotation. Anatomic implants because of their shape have a specific orientation that the implant must be placed in. In anatomic implants a majority of the volume is in the lower pole of the breast. In order to help keep the correct orientation, the anatomic implants are textured, which means they have a rough surface which helps allow the implant to stick to the underlying breast tissue and muscle. Despite texturing, anatomic implants can still rotate in the pocket which can alter the shape of the breast. Round breast implants can rotate and this is not significant because the orientation is the same in every direction. Another disadvantage of anatomic implants is the cost. Anatomic implants as a result of the texturing and the special equipment that is required to produce them results in a higher cost. With added cost, increase risk for complications, and the inability of even plastic surgeons to tell the difference between the anatomic and round breast implants, I feel the vast majority of patients would be best served with a round implant.