what make a breast augmentation look fake? do i like fake or natural? (photo)

Hi II,Generally the larger you go the "more bimbo-like" you look.  It is so great you have a photo to show your PS what you are looking for, exactly.  Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements. We put your photos on a large computer screen
for imaging, and go over your “ideal-size” photos. We then save this
information to your password protected “web account.”

First and
foremost the implant should fit the dimensions of your breast and tissue cover.
Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of
your breast "foot print". The average size
chosen over our last 7,000 breast implants was “350cc”. BUT, 90% of our patients tell us they wish they were bigger a year after
BA. (We will see you every year for
routine checks at no charge.) It’s like your mind incorporates the "new
you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra. The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues. Multiple measurements need to
be taken to fit an implant to your exact anatomy. Have your surgeon's office
show you the charts of the implant dimensions for the various profiles of
silicone and saline from the manufacturer. Then you and your surgeon can
piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan. Keep in mind
larger implants tend to have more problems over the years. Since silicone implants wrinkle less than saline
implants, they might be your best bet.

You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra. Wear this around the house for a while, and
see what you think. Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion.


Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively. Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover. Finally,
your verbal requests are factored into the analysis.

We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals. It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published
studies of BA patients, 95-percent of women interviewed after the procedure
returned to normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.” These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals. Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.

Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.
Does the PS offer all three incisions?
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."
Ask to see their before and after photos if you didn’t see any on their
website. If they are experienced, they should have several 100 breast
implant patients for you to view. I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you. You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.

All the best, “Dr. Joe”

Good questions. Much of the final look and feel 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. Careful measurements (dimensional planning) and careful selection of breast implant size/profile are part of the surgeon's responsibilities.
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. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. A higher profile silicone gel breast implant or overfilled saline filled breast implant may help to achieve a more "fake" look.

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 or D cup” etc.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I hope this, and the attached link (dedicated to breast augmentation concerns), helps. Best wishes.

"Fake" is certainly relative, and there are varying degrees of "obviously-augmented" appearances. It's easy to determine the high, round, "Baywatch coconut" look as "fake," and equally easy to see dramatically large, over-augmented breasts that cannot be natural, even in a bra or swim top. Poorly-concealed, badly-positioned, or poorly-healed scars and visible ripples when bending over are other obvious signs of (poorly) augmented breasts that indeed do look "fake."Most women prefer close cleavage, and usually plastic surgeons who are skilled at their craft are able to create augmented breasts that have nice cleavage, but this also usually requires a bra or swim top, just as your photo shows. Should that same cute woman wear a Renaissance Festival corset and revealing bodice, her upper breast poles can be pushed into a very tight, round cleavage, even with relatively small breasts (and particularly so with larger breasts!) so you can see that if the augmented breasts are soft and move nicely within their respective submuscular pockets, they can be both soft and naturally-shaped when nude, and full and round at the top when clothed and pushed as desired.Capsular contracture, however, tightens the scar around breast implants, and gives a high, round, "fake" look that also feels hard and is always unnatural, nude or clothed. They cannot be pushed any way but stay round and unnaturally hard. This is decidedly NOT the way to look high or round with upper pole cleavage.You may be interested in more information available in my Comprehensive Guide to Breast Augmentation, available by clicking on the web reference link below. Best wishes! Dr. Tholen