Changes to Chest Surface Anatomy Following Exchange From Anatomic Textured Implants to Smooth Round Implants in Breast Reconstruction: A Preliminary 3D Imaging Analysis

<b>Introduction:</b> Increased awareness of textured breast implants' association with breast implant-associated anaplastic large cell lymphoma has led to rising rates exchange from textured anatomic implants to smooth round implants, which can alter breast esthetics. This study used 3-dimensional (3D) imaging to evaluate breast shape changes following textured anatomic to smooth round implant exchange in breast reconstruction patients. We hypothesized a decrease in upper pole fullness after conversion to round implants. <b>Methods:</b> A retrospective review was conducted of breast reconstruction patients who underwent exchange from textured anatomic to smooth round implants between January 2019 and December 2020. Patients with preoperative and postoperative 3D images were included, excluding those with concurrent or prior fat grafting. VECTRA 3D imaging measured changes in breast surface projection. Linear regression modeling was used to evaluate associations between projection changes and body mass index (BMI), implant volume, and implant type. <b>Results:</b> Ten patients (18 breasts) were analyzed. The mean volume of round implants was significantly larger than anatomic implants (486.7 vs 453.9 mL, <i>P</i> = .01). All breasts exhibited superior hollowing postoperatively, with an average projection loss of 1.4 cm (SD = 0.8 cm). Regression analysis revealed no significant associations between projection loss and implant volume change (<i>P</i> = .887), BMI (<i>P</i> = .481), or round implant style (<i>P</i> = .389). <b>Conclusions:</b> Exchange from anatomic to round implants results in significant loss of superior breast projection. VECTRA imaging underscores these changes, aiding patient counseling and surgical planning. Fat grafting may help address these issues, warranting further research.