Breast Implants, 270ml Teardrop Over Muscle, Unnatural Looking? (photo)

Hi, I am booked in for breast augmentation for 14/5/12. I am after a natural result in proportion to my frame. After consultation with my plastic surgeon he has recommended 270ml Brazilian silicone, high profile teardrop implants placed over the muscle. One of the other size options I was given was 315ml which I am now considering. After further research however I am worried about going over the muscle if I will get an unnatural result, especially if I choose the larger implant?

Doctor Answers 7

Best Breast Implant Shape/Positioning for Me?

Thank you for the question and pictures.

You will find that plastic surgeons may  have different preferences/recommendations for you. This does not necessarily mean that one recommendation is better than the other.

My preference/recommendation for you would be round silicone gel breast implants  place in the partial sub muscular (dual plane) position.

I think it is in your best interests (and that of most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).
The submuscular positioning  also tends to interfere with mammography less so than in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

One of the known problems/complications associated with “anatomical” or "teardrop" breast implants is the possibility of shifting/rotation of the breast implant.  This rotation of breast implant may cause the breast shape to change,  potentially necessitating further surgery to correct.  For this reason, and with the goal of minimizing complications and need for further surgery, I prefer the use of round implants for almost all patients.

I hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Natural resulting breast augmentation

 You asked for an opinion, so here you go. As you can see from the physician responses stated below, results with breast implants are very surgeon specific, however, in my opinion there is no better option than a sub muscular dual plane  silicone implant for your frame. You will have a beautiful result with a smaller teardrop shaped implant underneath the muscle. Going too large or going on top of the muscle, will leave an unnatural and palpable result in someone in as good a shape as you are. 

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.9 out of 5 stars 32 reviews

Choosing implants

Thank you for the question. As I stress with my patients, the choice of implant size and type would best be done through an in-person examination. There are a lot of factors that can affect your choice like the desired end result, breast tissue, body measurements, and the like. Bra sizes can be better determined once all of these information have been gathered. It would always be best to visit your board-certified plastic surgeon and get a full evaluation for your concerns. Best of luck, Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 95 reviews

Teardrop Implants Tend To Rotate

Implants under the muscle statistically stay softer, have a more natural look, and one gets a better mammogram when implants are in the subpectoral position.  All anatomic implants (teardrop) are textured, and unfortunately textured implants which are thought by so many to stay soft, have a tendency to get hard, and at times, rotate.  All things being considered, I would have another consultation with your plastic surgeon to discuss alternatives to textured, teardrop implants in the superpectoral space. 

Breast Augmentation Shape and Position

 I believe that placement of your implant over the muscle may show the top edge of the implant.  Based on your picture I would place the implant underneath the muscle.

Good Luck


Dr. ES

Breast Implant Placement

Hello Gail,

I would not recommend placing a breast implant over the muscle, except for very unique situations, like professional bodybuilders who prefer it that way.  For most women, placing implants under the pectoralis muscle allows for a number of benefits, including a more natural upper pole appearance of the breast due to the increase thickness of tissue coverage by the muscle, a lower risk of capsular contracture, and better breast tissue surveillance with mammograms.

Unless you have specifically opted for a gummy bear implant, which is a firm type of gel that is 'form stable' (doesn't change shape and so it has to look like a teardrop or breast shape), I would recommend a round implant that is smooth walled.  This smooth round implant will not have rotational problems and tends to ripple less.  Although the gel is also cohesive, it is softer and allows the implant to take on a teardrop shape in your body.

A final note on size.  You appear thin and petite, and choosing a larger implant will not only make you look 'augmented', ie. not natural, it also puts you at risk for rippling and visibility of you implant.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Teardrop implants

Teardrop implants are to be avoided. They can rotate the wrong way and create undesirable distortion.  Stick with round implants.  Many  surgeons  have answered similar questions and say the same thing.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 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.