Hundreds of thousands of women have their breasts augmented each year in the United States, and those who have had great breast augmentations don't look artificial - they look beautiful and natural, with breasts that are full but in harmony with their figure. They look great, they wear what they want to and fill out their clothes nicely, and the surgery they have had is their little secret.
When the goal of this operation is a natural-appearing breast enhancement, the results can be absolutely beautiful. However, if the goal is to create an excessively full breast profile which is out of proportion to the shoulders, waist and hips, then the results - by definition - never appear natural. These patients not infrequently end up having a series of operations to address problems related to the excessive implant volume.For any patient considering breast augmentation, there is an implant size above which the upper pole begins to look rounded, convex, and unnaturally full. Mild to moderate upper pole fullness can look beautiful and youthful, but excessive upper pole fullness due to overly-large implants looks decidedly fake, and like what most people think of as a 'boob job'.
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.
n many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold.
Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).
The horizontal position of breast implants also requires a great deal of attention, both in pre-operative planning and in the operating room. Excessive lateral dissection of the implant pockets will result in augmented breasts with an excessively wide space between them in the cleavage area, and the appearance that the breasts are abnormally far apart. The result may (or may not) be tolerable in the upright standing or sitting position, but when the patient lays down in supine position (on one's back) the implants may fall far to the side and produce little to no anterior breast projection in this position. Patients with the problem almost always want it corrected, and the treatment once again is surgical: a lateral repair of the implant space, to restrain the implants from falling off to the side.
Inadequate lateral dissection, on the other hand, will result in an augmentation with an abnormal 'side by side' appearance. It is lateral projection of the breasts beyond the lateral border of the chest wall (in frontal view) that, along with the concavity of the waist profile and the convexity of the hip profile, produces the appearance of an 'hourglass figure'. While one does not want to over dissect the lateral extent of an implant pocket, careful attention must also be paid to ensure that lateral breast projection is not inadequate.
Breast implant base diameter is also of crucial importance. The base diameter (the side-to-side dimension of the implant) must be ideal for the existing horizontal dimension of the breasts preoperatively, as well as the breadth of the anterior chest in general. Obviously, a given implant volume and base diameter that works well for a small-framed patient that is 5'3" will be completely inadequate for a broad-chested patient who is 5'10". One wants to increase cleavage area fullness and lateral breast projection in most cases, and an implant of inadequate base diameter may accomplish only one of those goals, while too wide an implant will be overprojecting in both directions. Careful evaluation of all of these breast and implant dimension issues is necessary if the ultimate goal of the surgery is a natural-appearing breast augmentation.
First of all YOU need to be the one who wants the implants, not just your husband. Assuming that is the case,breast implants can look and feel very natural but it depends on several factors. Generally speaking , the more the patient brings of themselves to the final result the more natural the result will look and feel. The more the implant brings to the final result, the less natural the look and feel. Silicone gel implants look and feel more natural than saline implants. Implants under the muscle often look more natural.
For a natural look, sub muscular placement (under the muscle) silicone implants are the best. The more breast tissue you have, the more natural the result you will have.
The key to attractive natural breast implant augmentation is to match your body with the best implants that would fit and enhance it. Although anybody can strong arm and stick an implant in a woman's breast - we have all seen the results of such "augmentations".
It is BEST to pick an implant that would be totally covered by your breast tissue (which would better hide the ripples ALL implants have), that based on your chest wall would fir on the flat, front plateau of your chest (and not fall to the sides), that would have less rippling and leak less often (avoid textured implants, especially over the muscle) among others.
Personally, I would NOT operate on you if I knew your husband was pushing you into having this done. Cosmetic Surgery is a VERY personal decision which should NEVER be done for anyone else.
If it's your husband that wants you to have implants and not you, then I suggest you do not get them. It is your body and only you can decide what should be done.
Having said that, both silicone and saline implants can achieve natural looking breasts. It all depends on the expertise of your surgeon and proper implant selection.
Thank you for the question. There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. Online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural big C cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps.
Best wishes for an outcome that you will be very pleased with.
augmentation patients not only want implants that look good, but feel good, as
well. They want implants that feel
natural and behave like natural breast tissue.
Several factors are associated with
implants that feel natural.These
include the use of silicone implants, the use of smaller implants, and a high
ratio of native breast tissue to implant volume.When these variables are favorable, breasts
tend to feel more natural and behave like normal breasts.
The majority of breast augmentation
patients are happy with how their breasts feel.Occasionally, patients develop hardening of their breasts secondary to
capsular contracture.When this occurs,
secondary revisional surgery may be necessary.
If you’re considering breast augmentation,
consultation with a Board-certified plastic surgeon is appropriate.This surgeon should be able to formulate a
plan for breast augmentation that results in breasts that feel natural.
Natural appearing breast augmentation has many key factors including implant type, size, pocket placement and incision type. The other key factor is the patients pre-existing breast shape and volume. After having children your breast skin and tissues have been stretched and then shrunk, which commonly disturbs the internal and external support of the breast. Also, the breast tissue appears smaller, so in order to make your breasts appear as natural as possible I would recommend a conservatively sized silicone implant placed under the pectoralis muscle via an incison which is hidden in the breast fold, though you may need a breast lift, which may necessitate additional scars.
Work with your board certified plastic surgeon to discuss your options based on your body and breast type. I hope this helps.
In order to achieve the most natural feel with breast implants, I would recommend considering the cohesive silicone gel implants. Although both the saline and silicone implants can give you a beautiful look, the silicone implants tend to have a more natural feel than the saline since the feel of the silicone material feels very similar to the natural consistency of breast tissue.
In general, the more breast tissue that you have naturally covering the implants, whether they be saline or silicone, the more natural the feel you will have after surgery. It is important that you choose an implant that will fit your body frame, and there are multiple profiles to choose from. This is best done with you meeting with your doctor and telling him or her what your expectations are, and then going over the options for your desired volume, cleavage, projection and diameter. Good luck!
Natural breast augmentation can be achieved by carefully measuring your breasts to make sure the implant which is chosen will perfectly fit your body. For increases of one cup size, a low profile implant is generallly adequate and natural looking. Increasing the amount of tissue over the implant will hide the implant and prevent visible rippling of the breast. This can be accomplished by putting the implant under the chest muscle (pectoralis major muscle) so that the muscle helps cover the implant. Silicone implants feel more natural than saline and can contribute to a more natural result.