Why don't I have roundness on top? (Photo)

Unless your breast skin "brassiere" is altered and shaped via incisions, breast implants only "fill" the breast "container" into which they are placed. Implants add volume only, but the shape is determined by your pre-operative anatomy. If you want perky or uplifted breasts, shaping incisions (breast lift) are required.Of course, many of the high, round "Baywatch coconuts" you see are not due to some special magic with implants, or particularly-skilled surgeon, but rather to capsular contracture, which is a sort of internal (abnormal) tightening that makes the breasts hard. Trust me, you may like this look, but you don't want the "feel."Larger implants may give you more "fill" and therefore more tightening of the skin, but skin always stretches and ages. You have a splendid result for the degree of breast ptosis you started with. BTW, high profile implants do NOT give more upper pole fullness, as you will frequently read here and elsewhere. These round implants have a narrow diameter (and more projection for implant volume), and once they drop, soften, and settle (which they all do unless capsular contracture is developed), they have a shorter height (vertical diameter) and MORE indentation below the collar bones--LESS upper pole fullness. The widest profile implants that fit your breast bases will give the highest vertical height, and the most upper pole fullness. HP implants only give more upper pole fullness before they drop!You are slim with a beautiful breast augmentation result. A good push-up bra will give you all the fullness superiorly you wish for. Undressed, you have the benefit of soft, natural breasts! Best wishes! Dr. Tholen

Rounded upper poles or exaggerated upper poles are usually the result of implants too large for the breast, capsular scar contracture, or thin tight chest wall to begin with that gets stretched with an implant...if you have ptotic( droopy) or more natural appearing breasts prior to surgery, you will likely have " natural" hanging breasts after augmentation....unless you over augment( choose very large implants) and/or add a lift/mastopexy as part of the surgery.your results look very nice and appropriate.hopefully you communicated your desires fromyour augmentation with your plastic surgeon prior to your augmentation.best of luck to youDr Terry Higggins

Thank you for the question and picture. What determines whether a patient will have “roundness” of the upper poles of the breasts include factors such as type of breast implants, size of breast implants, positioning of breast implants, and the amount of native breast/soft tissue present. For example, the more natural breast tissue present, the more  difficult it may be to achieve the round/full/augmented look that some patients desire. I hope this, and the attached link, helps. Best wishes.