The last 12 months has seen a lot of exciting developments in the field of breast implants. In fact, we have seen changes and advances in the last 12 months that have outpaced the previous 10 years. First, the duopoly enjoyed by the two principle breast implant manufactures in the United States was broken up by the introduction of the Sientra implants in early 2012. Now there are three companies from which surgeons can choose implants which means patients and surgeons benefit from a wider array of choices. Second, two more advanced types of implants have been FDA approved for use in the United States, the Allergan 410 and the Sientra anatomic gel implants. These are unique in that they represent a 5th generation of gel technology that is more cohesive and form stable, meaning that they are shaped more like a breast and keep their shape. Furthermore there is early evidence that these anatomic shaped form stable gel implants have lower complication rates, but the data is premature at this time. There is still no one perfect implant that is a solution for every patient, but now there are more choices available for patients and surgeons that can further improve aesthetic and reconstructive breast surgery outcomes.