Concerned that Implants Will Just Give Me a Larger Version of My Breasts Now, Which I Don't Like, Options? (Photo)

Hello Doctors I’m am considering breast augmentation However I have two big concerns…. 1) dislike the shape of my breasts I’m worried that implants will just make them larger versions of themselves.It is the shape that really bothers me much more then the size. 2)I want VERY NATURAL looking implants.I really want a lot of “lower pole” fullness and dislike a lot of “upper pole” fullness. What are your thoughts on 250 cc round moderate profile silicone implantunderneath the muscle? Thank you

Doctor Answers 27

Natural Looking Breast Augmentation

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A natural-appearing breast is noticeably fuller in the lower pole (below the nipple) than the upper pole. In profile (viewing from the side), the upper pole slopes gradually from where the breast begins in the upper chest down to the nipple, and the lower pole is full and rounded. For any patient considering breast augmentation, there is an implant size above which the upper pole begins to look rounded, convex, and unnaturally full. Mild to moderate upper pole fullness can look beautiful and youthful, but excessive upper pole fullness due to overly-large implants looks decidedly fake, and like what most people think of as a 'boob job'.
In many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold.
Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).
The horizontal position of breast implants also requires a great deal of attention, both in pre-operative planning and in the operating room. Excessive lateral dissection of the implant pockets will result in augmented breasts with an excessively wide space between them in the cleavage area, and the appearance that the breasts are abnormally far apart. The result may (or may not) be tolerable in the upright standing or sitting position, but when the patient lays down in supine position (on one's back) the implants may fall far to the side and produce little to no anterior breast projection in this position. Patients with the problem almost always want it corrected, and the treatment once again is surgical: a lateral repair of the implant space, to restrain the implants from falling off to the side.

Breast implant base diameter is also of crucial importance. The base diameter (the side-to-side dimension of the implant) must be ideal for the existing horizontal dimension of the breasts preoperatively, as well as the breadth of the anterior chest in general. Obviously, a given implant volume and base diameter that works well for a small-framed patient that is 5'3" will be completely inadequate for a broad-chested patient who is 5'10". One wants to increase cleavage area fullness and lateral breast projection in most cases, and an implant of inadequate base diameter may accomplish only one of those goals, while too wide an implant will be overprojecting in both directions. Careful evaluation of all of these breast and implant dimension issues is necessary if the ultimate goal of the surgery is a natural-appearing breast augmentation.
Take a look and many, many before and after photos. If a plastic surgeon consistently has results that look natural to you, chances are you share a similar aesthetic sensibility and you'll be pleased with your result.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

I want natural looking breasts

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Dear fakeit1,

You have an asymmetry of your breasts that Dr Aldea has accurately described.  I think that implants would give you a nice result but you would have to be realistic in your expectations.  There would still be some asymmetries and so it is important to carefully go through what your goals are with your surgeon.

Anatomically shaped or teardrop implants often give a more natural shape with less upper pole fullness and this is something that you could consider, again, in consultation with your surgeon.

I recommend that you have another consultation and keep going over things with your surgeon until you are both happy that you are each aiming for the same thing.  Good luck.  Jonathan Staiano.

Can Implants Change the shape?

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Yes, done by an expert you can have more fullness in the lower half, BUT you have very little space between the lower edge of the areolae and the crease. You will need your crease lowered and that requirea an expert to avoid the dreaded Double-Bubble!

Dr Foster  Lake Tahoe Plastic Surgery

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon

Breast implants can improve breast shape

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It is often best to think of implants as adding volume and breast lifts or other breast tissue type procedures as shaping the breasts.  With that said, breast implants alone will change the shape of certain breasts and your breast may be a good example.  As you have stated your lower breast pole volume is small.  This gives the appearence of a high inframmamary fold.  The fold may be the cause of lower pole deficiency as in constricted breast syndrome or a paucity of lower pole volume and breast volume overall may allow a strong lower breast fold to symply be tighter thereby appearing higher.  You do have some asymmetry as do most women but this can be addressed with slightly different sized implants.  The big question is two fold:  what are your expectations and how big of an implant would be ok to get the result you want.  A 250 cc may be a little too small but that cannot be accurately answered through the photo alone.  

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Breast implants and the shape/look of the breast

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In general, a natural looking result from a breast augmentation using breast implants is indeed your breast with its same shape looking bigger. This is also what would happen if your breast grew from added volume with growth or fat volume. An implant is just a pillow that provides volume and does not change the basic characteristics of the breast including normal asymmetry like the larger areola on the right and the slightly different inframammary crease position although it can offset the minor volume difference. 

In your case which is a very common situation for those considering breast augmentation, the inframammary crease level will have to be lowered to accomodate a round implant and get it centered behind the nipple position. This will fill out the lower pole of the breast and give it a rounder look. (It is also what gives the illusion of a lift). The gap between your breasts will stay the same distance apart. They will still be somewhat off-axis (turned out). But since they will be at least a cup size larger and rounded out they can look better. I would not advise a high profile implant.

It is important to understand what breast implants do and don't do and have realistic expectations. If the implant is not fitted, positioned, or healed properly than you will be dealing with unnaturalness as well. 


Scott L. Replogle, MD
Boulder Plastic Surgeon

Breast Shape and Symmetry Can be Improved with Appropriate Implant Techniques

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Hi there-

It is first important to understand that the details of your procdure would not be appropriate or responsible (in my opinion) for any surgeon who has not examined you in person to recommend- and therefore I won't.

On the other hand, I think it is safe to say that while basic breast augmentation technique would most likely do exactly what you are afraid of- create only larger versions of the breasts you already have, a skilled and experienced surgeon should be able to modify the technique used in order to improve the shape, position, and symmetry of your breasts. I do not think that perfect, exact symmetry is possible for you, but a significant improvement should be possible.

Choose your surgeon carefully.

Breast shape after augmentation

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Generally, augmentation does not change the shape of the breasts.  Certainly, the different profiles of available implants will influence the post-operative result.  It's important to have reasonable expectations.  Personally, I favor the type of augmentation you are seeking in terms of the volume you wish to add to your breasts.  I always advise patients, especially those in their 20s or 30s, that any weight gain later on will be reflected in breast size so it's wise to have a more modest augmentation in this age group to fit the rest of your body.  You can expect five surgeons to give you five recommendations in terms of the volume, type of implant and method of implantation so definitely do your homework AND, most importantly, make sure that your surgeon is certified by the American Board of Plastic Surgery and the facility accredited by either the Joint Commission or AAAASF.  Also, don't hesitate to inquire about the anesthesiologist's credentials as well! Best of luck!

Natural look from breast augmentation

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without knowing your measurements in terms of breast base width and ribcage measurements, it can be difficult, but I think you would likely be close to your desired shape. Having said that, a breast implant will not significantly change the structure of the native breast tissue. It mirth cause some sagging and some  flattening of the breast in some cases, but changing the shape of your own breast by placing an implant alone is not always reliable.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Breast shape after augmentation.

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Your question is a good one and one you should discuss this in detail with your surgeon. Basically it comes down to this 1) there are multiple shapes and sizes of implants than can effect the final result , and 2) the initial shape and skin envelope of the breast will effect the  final result.

Concerned that Implants Will Just Give Me a Larger Version of My Breasts Now, Which I Don't Like, Options? (Photo)

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Thanks for the photos. I recommend at least a 300 HP implant. Best to see boarded PSs in person. Regards Dr. B

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.