Will Small Breast Implants Give Rock-in-a-sock Look?

I am 5'10" and weigh 145 lbs. I have an athletic build, and I'm not even an A cup. Before having kids, I was a slight B and very happy. I would like to go back to that, but the surgeon said if I go with a smaller breast implant, I would get a "rock in a sock" look. Is there anyway to go small/athletic and not have this happen? Aren't there wider diameter implants without such a high profiles that would fill out my breasts without bringing me to a C?

Doctor Answers 8

Breast implant sizing

Thank you for the question. It sounds like direct examination will be necessary to give you accurate advice. Some general advice regarding breast implant sizing  may be helpful.

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.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Implant choices

Without an exam it is hard to say, but a small implant in someones who needs a lift can give the look you described.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

VIDEO (Click HERE) Will Small Breast Implants Give Rock-in-a-sock Look?

A rock in the sock deformity usually occurs with a small implant inthe subgalndular position insdie of a pendulous ptotic breast.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Small implant vs. "rock in a sock" outcome.

Hard to tell without photos, or better yet seeing you in person.  You goal of up-sizing seems within the realm of possibility.  The issue of rock in a sock is usually more dependent on soft tissue and skin.  If there is redundant soft tissue a lift may be in order.

I would find some photos that you like, and I would also look around a a couple of other Plastic Surgeons.  Please make sure they are Board Certified by the Amer. Board of Plastic Surgery.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Getting things right for the breasts


You can probably get to where you want to go but might need a breast lift. It is of course difficult to tell without seeing you. Get a few opinions and listen for a consensus, amongst good surgeons, of course.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast implant sizing

Typically, an extremely natural look can be achieved with the size change that you are interested. The rock in a sock look usually occurs when breast implants are placed without a lift in a patient with a great degree of sagging. With the size of your breasts, it is unlikely that you have a great degree of sagging. If you do have sagging, a breast lift would correct the sagging without requiring a larger implant.

Michael Horn, MD
Chicago Plastic Surgeon
4.4 out of 5 stars 54 reviews

Breast implant consultation and sizing

It sounds like your goals are achievable. As part of the breast consult process, measurements are taken of the chest and breast. These measurements along with an assessment of the overlying skin and tissue helps determine implant options. As you correctly point out there are implants available that have wider dimensions and less projection(fullness).

You may want to schedule a follow up visit or get other opinions.

John E. Gross, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast implant decisions

The size of the implant really has nothing to do with the "rock in the sock" look and it sounds like your desire to have a very natural, conservative look should be quite obtainable. Not only should your goals be obtainable but you should be able to have a long lasting result that you will be happy with, as choosing a smaller implant that fits the frame of your body will often give a more sustained result.

Unless you have a significant amount of excess skin which may necessitate a simultaneous breast lift, you should be able to accomplish your goals with the a small implant. My advice is to see another plastic surgeon (board certified of course) or two for additional consultations / opinions to help you make your decision.

Dr. Sean Simon

Miami, FL

Sean A. Simon, MD
Miami Plastic Surgeon
4.2 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.