Which Breast Implants Result in Natural Slope and Cleavage?

Once you have selected a volume based on the visual you get from trying on sizers, the surgeon can use the measurements to determine which implant will give you the look that you desire.  If for instance you are using saline high profile round implants, you can achieve natural if you are at the low end of the volume range of a larger implant, if you choose a smaller implant and fill it to the middle of the range to get to the same volume you will get more cleavage and an intermediate look, if you choose the smallest implant that can be used to get to the same volume, and fill it all the way up, it will be the most projected of the three looks.  For silicone, you just need to look at the dimensions of the implants and decide with the surgeon which will give you the projection you are looking for.

It’s important to understand
that breast implants come in all shapes and sizes. Choosing the right implant
depends on several variables including the patients underlying anatomy and
personal preferences.

 

         Two of the more
popular implants are the round moderate plus and high profile varieties. These
breast implants have important differences and specific indications.

 

         The majority of
patients require a round moderate plus implant. This implant gives a more
natural appearance. It has a broader base width and less anterior projection.
This results in a more natural slope and more cleavage.

 

         In contrast, the
high profile breast implant has a narrow base with more anterior projection.
This implant is indicated when women desire more projection, and upper breast
fullness. It tends to give a more artificial appearance.

 

         Although, it’s
impossible to know what implant is right for any individual without performing
a physical exam, the majority of patients require a moderate plus implant.

 

         If you’re
considering breast augmentation, the style of implant chosen is one of the more
important considerations. Make sure, you discuss this issue with your plastic
surgeon so you can obtain the best possible result.

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 or breast "look".  

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.