Which Breast Implants Result in Natural Slope and Cleavage?

I offer patient's a simple analogy to illustrate what we mean:

Q: If you take a baseball and you cover it with a silksheet, what will it look like?

A: Like a baseball, you will even see the stitching.

Q: Now if you take that same baseball and cover it with a comforter what will you see?

A: It depends on how thick the comforter is but generally you will see a softly shaped lump.

So now the question is what do you have on your chest, silk sheets or comforters?

The way we determine this is by looking at your chest, if I can see your ribs (under the muscle) then you anatomy will have a hard time disguising the implant whether it is placed under or over the muscle and you are more likely better off with a silicone implant. Another way of measuring this is to pinch your upper chest skin (similar to pinch and inch of your waist on the Special K commercial). If you have less than an 2 cm (under 4/5 of an inch) than you have "silk sheets"

If you have a thicker skin/fat/breast layer that pinches over an inch than you have the option of going under or over.

Now the exception to the rule:

Q: What happens if you change the baseball to a volleyball?

A: All bets are off, whether you put it under or over the muscle it will not look natural.

The last issue is the implant shape. A moderate or moderate plus implant that has minimal projection is more likely to be more natural appearing (less baseball like). However many paitents seek upper pole fullness and larger volumes with a small BWD and the only way to achieve this is with a high profile implant.  There are some anatomic shaped implants but I have generally found them to produce no significant difference in outcome with the exception of breast cancer reconstruction. However, this is my personal opinion
 

The current trend in breast
augmentation is for a more natural result.
There are several new additions to the breast implant family that makes
this much easier for your plastic surgeon to help you achieve this goal.

One the use of silicone implants has
made a dramatic change in terms of natural feel and shape. The silicone implants over saline implants
are much softer and look much more natural.
With a silicone implant a patient would have to place a much bigger
implant to have a very round “fake” appearance.
This is because the saline implants are very firm and thus create this
round unnatural shape. The silicone
implants because of how soft they are tend to give subtle and natural
appearance.

The other new addition is the use of
shaped implants. Shaped implants are
great for patients that a very afraid of looking overly round and fake. The shaped implants are made with a natural
slope to them, this way patients can have more natural shape with their
augmentation. The shaped implants have
been great for my breast reconstruction patients and for patients that want a
larger implant, but still want to look natural.
In smaller implants the difference between the silicone shaped and the
silicone round implants is very little.

Please discuss your breast augmentation
surgery with your board certified plastic surgeon and let them help guide you
during the process.

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.

Simply put: Pick the best plastic surgeon that you trust, be clear about your desired outcome and let him/her select the best implant. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.

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.