Will 225 and 275cc subglandular, high profile implants give me a natural look? (Photos)

Dear Lexi Reid,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your surgeon obviously had the advantage of examining you, but in general, I agree with your impression that a more natural outcome tends to be achieved when the implant is placed under the muscle, thus achieving a slight upper pole flattening and therefore mimicking the natural breast. It is impossible to know ahead of time if you need a 50 cc difference or less or more, but it is important to realize that fine tuning your asymmetry can only be achieved using a saline filled implant. That said, it is generally agreed upon that our eye can rarely distinguish differences of less than 20 cc's in breast size. And as you probably well know, chest wall asymmetry such as you appear to have, is extremely common.

If you have doubts or concerns after your initial consultation you might be advised to see a second opinion. It is important to also keep in mind that a subtle asymmetry is likely to persist even with the optimal breast augmentation. I recommend using photos of your "ideal" outcome to share with your plastic surgeon to make sure you are both looking at the same picture. Words such as "natural" can mean different things to different people. Best of luck to you.