Can I Have Larger Implants Without Having the Fake Look? (Photos)

I am 5'7", 125lb. I have a BWD of 11.9. Will 400cc HP Implants make me look fake? I tried on the sizers and found that I liked the 400 cc Mentor Mod+ sizers the best, considering they would be slightly smaller than that when they go under the muscle. My doctor told me with that size that I'd have to go high profile. After a few days and reading a bit online, I keep seeing that high profile implants give that fake stripper look. Will 400 cc HP give the overly fake look? I'd like to move down in profile, but then it would go above my BWD. Is it safe to go above my BWD?

Doctor Answers 7

Choosing a breast implant size

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There are many factors to consider when choosing a breast implant.  Implant volume is only a piece of the puzzle.  Selecting an implant that is close to or matches your BWD is also important.  Some women like more fullness with the breast silhouette extending past the rib cage, and in that situation the BWD and implant base measurement does not necessarily have to be the same.  When comparing implant volumes, the high profile implant has the narrowest base with the most projection, which is what you are perceiving as the "fake stripper" look.  High profile implants do look more defined, and if you do not like this appearance, I would suggest a lower profile implant to achieve your goals.  I find it most helpful to review photographs with my patients to get a better visual idea of what their goals are for surgery.  Putting an implant inside a bra does not necessarily translate into what you final result will be!

Dallas Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast implant sizing

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The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Breast implants

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The larger you go in volume the less natural the implants will look. I have put in many implants of the size you mentioned and the patients that choose that volume seemed to be very happy with their choice.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant size for a natural look

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400 cc is a fairly large imlant..  is your chest 32 ,34 or 36 ..  this will affect the implant size..   the most natural look will be a large b or small c cup which will certainly be smaller than 400 cc for you

hi profile implants can look natural in the right size and patient

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Natural looking breast augmentation.

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You can have naturally looking augmented breasts by getting appropriately sized for an implant by a board certified plastic surgeon and preferrably using the shaped cohesive gel implants. There is a larger selection of implants that can match your BW. I use those implants for women like you who want to have a natural looking augmentation. Good luck !

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 76 reviews

Natural breast augmentation

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All implants have the potential to produce a natural and a fake look. It is all about how the individual implants are used and under what specific circumstances. I have written extensively on this subject so please feel free to review those previous posts. In general, the most natural agumentation in a breast that starts out small but natural in shape is the least projecting (i.e. lowest profile) implant at fits within the base width of the natural breat. It also has to do with the relative proportion of the final  breast that is implant versus natural breast tissue. The higher the profile, the wider the width beyond the natural base width, and the higher proportion of fina breast that is comprised of the implant, the less natural the breast will look and the more the breast will take on the characteristics and potential negative side effects (i.e. excessive roundness, rippling or wrinkling, firmness, etc.) of the particular implant you choose.

Robin T.W. Yuan M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Breast Implant size for natural results

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If you want a natural looking result, start by finding a plastic surgeon with many many before and after images that you feel have a natural looking appearance. That is sone way to determine whether or not you and your surgeon have the same aesthetic ideal.

The actual size of a breast implant, measured in cc's, is really not very descriptive of what a breast augmentation will look like, or what the cup size will be. It is all relative to the size of the breast and the size of the patient preoperatively. A tall, broad-shouldered patient with small A-cup breasts may require 450cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a 250cc implant to achieve a C-cup breast volume.

If a natural appearance is the goal, then the way to get the size right is to 'try out' different implant volumes and profiles in the operating room. Once the implant pockets have been created, sterile sizers can be placed in the implant pockets, and the upper half of the O.R. table raised so that the resulting breast appearance can be assessed with the patient in an upright 'sitting' position (chest fully upright) while under anesthesia. These sizers are available not only for each implant size but also for each implant profile: low, moderate and high (in this practice we use high-profile implants only in rare instances). Inflatable sizers are used for saline implant augmentations, and pre-filled gel sizers are used for gel implant augmentations.

For any patient there is obviously a range of implant volumes that would be considered natural-appearing, and a volume at which the upper pole of the breast begins to look very unnatural. While one patient may seek an augmentation that is 'perfectly natural', another may be interested in a result that is more on 'the full side of natural', and many patients do ask that the largest implant volume be selected that does not produce an unnatural fullness in the upper pole. By using breast implant sizers intra-operatively to determine exactly what breast implant profile and volume produces the best breast appearance in the O.R., patients can be provided with the closest possible approximation of their preoperative goals, and can be assured of a natural-appearing result.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.