Commentary on: Do Not Fear an Implant’s Shape: A Single Surgeon’s Experience of Over 1200 Round and Shaped Textured Implants in Primary Breast Augmentation

It is with great pleasure that we discuss "Do Not Fear an Implant's Shape: A Single Surgeon's Experience of Over 1200 Round and Shaped Textured Implants in Primary Breast Augmentation" by Montemurro et al.¹ In this article, the authors reviewed their 6-year experience using textured, anatomically shaped and round silicone gel implants in 648 patients for primary breast augmentation. They specifically examined the complication rate for both types of implants. All implants were placed through an inframammary incision into a dual plane pocket, except for 2 patients who had implants placed in a subglandular pocket. A total of 581 patients had anatomically shaped implants with an overall complication rate of 9.0% while 67 patients had round implants with an overall complication rate of 11.9%. Rotation (3.6%) was the most common complication to occur with anatomically shaped implants while bottoming out (7.5%) was the most common complication after round implants. The difference in overall complication rate was not statistically significant (P = 0.505). The authors conclude that "a single, ideal implant that is suitable for every primary breast augmentation does not exist and one implant shape is not, by itself, aesthetically superior to another." Although we would agree with this statement, there are several important issues requiring further discussion.