Are there techniques surgeons can use to ensure lower pole fullness and a definite slope from clavicle to nipple?

Obviously surgeons can't guarantee that surgery results will be exactly what a patient desires, but can you perform specific techniques during the operation to increase the likelihood of certain characteristics? Most BA results appear to me as too full in the upper pole and with the breasts situated too high on the chest, looking like the breasts of a teenager. I'm hoping for lower pole fullness and nipples that point slightly upward. Are these requests too precise to be realistic?

Doctor Answers 12

Natural breast contour

There are several ways to do this.  it is difficult to look at before/after photos and determine what that patient may look like long-term and how that look may translate to your body.  Each patient has different tissue quality, elasticity, and native breast tissue which affects how "bubbly" vs "natural" the breast slope is.  In general, as upper pole fullness declines, most augmented breasts do settle into a more natural shape with lower pole curvature and nipple position.

Of course, the ultimate way to control this issue is to use an anatomical shaped implant that is shallow in the upper pole and fuller in the lower pole, but these are more expensive and smooth round implants can achieve a similar look in most cases. 

Discuss with your surgeon about appropriate sizing and your specific desires about shape, and he/she should be able to achieve a very natural contour.

Good luck,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia

Shaped or gummy bear implants can give a very natural look without a ton of cleavage

It sounds as though you're a great candidate for the shaped or gummy bear implants.  These implants have a more formed shaped that look like a natural breast without giving too much cleavage.  The actual procedure itself is very straightforward with minimal recovery time and discomfort.

Thank you for your question!

Dr. Schreiber, Baltimore plastic surgeon

Sloping implants

Thanks for your question. Natural breasts look natural because they take on a gentle slope from the chest wall, are smaller at the top and fuller at the bottom.Implants in general tend to give more fullness to the top of the breast which is appealing, but as you point out less natural.

Saline implants, are basically glorified water balloons, because of the way the water stretches the implant shell, these tend to give the most upper pole fullness.

Silicone implants, particularly under the muscle tend to take on a more tear drop shape and tend to look more natural. I favor smooth implants which move around inside their pocket, again looking more natural.

While there are specific teardrop shaped implants, these implants must be textured to adhere on the inside so that they do not rotate. Because of their stickiness and immobility I personally find them less natural.

Remember that whatever you choose pick a common sense size. as you go larger in any implant the result can look less natural. I have included sizing faq as well.

Best wishes.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

Are there techniques surgeons can use to ensure lower pole fullness and a definite slope from clavicle to nipple?

Thank you for the thoughtful question. Yes,  there are many variables that come into play when determining the specific aesthetic outcome achieved with breast augmentation surgery.  The patient's starting point, for example will determine to a great degree what can be achieved but surgical maneuvers can also play a significant role.  Exactly how/where the breast implant "pocket" is dissected and which breast implant size/profile is selected may play a big role when it comes to final aesthetic outcome achieved.

 My best suggestion: select your plastic surgeon carefully. Make sure that he/she is a board-certified plastic surgeon who can demonstrate significant experience achieving the types of outcomes you would be pleased with. Then, communicate your goals carefully as well.  The use of goal photographs and computer image may be very helpful during the communication process. After doing so, your plastic surgeon will be able to tell you whether or not the desired outcome is realistic, given your specific anatomic starting point.

 Best wishes.

Are there techniques surgeons can use to ensure lower pole fullness and a definite slope from clavicle to nipple

Every patient has different desires and there are many women that want a full round breast, even though that is not as natural. In your case, I think the biggest controlling factor is the implant choice. I think using a shaped implant is the best option as that implant already has the shape you are looking to have.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 reviews


Your expectations are in line with how most augmentations should turn out.  I agree that excessive upper pole fullness is unnatural.  Also nipple position should be slightly above and lateral to the apex of the breast.  If you discuss these desires your surgeon will be able to make adjustments to achieve these results.  

Breast shape

Most breast implants do not stay as high as some patients desire.  Fullness in the lower pole can usually be achieved pretty easily.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

I hope to have lower pole fullness after my breast augmentation

This is a very good question, and I agree with you about what constitutes a very nice shape after a breast augmentation.  You fortunately have a wonderful breast implant shape that can oftentimes produce this shape result.  The implant is called a teardrop, gummy bear, form stable silicone implant.  It is usually textured and slightly firmer than older style implants, thus reducing the likelihood of having capsular contracture scar tissue forming around it that would become thick and troublesome.  It will still form the scar tissue as all implants do, but it is believed that the amount and thickness of the scar tissue is greatly reduced.  The chance of rippling seen with this implant is also reduced.  I have used this implant a great deal in my practice and like the results for certain appearances for certain patients. You may want to ask your local Plastic Surgeon about this style of implant.  The shape obtained is often showing more central and lower pole fullness, with slightly less fullness on top.  In other words, it looks more like a breast!

Good luck to you.

Frank Rieger M.D.  Tampa Plastic Surgeon

Looking for a natural shape

Dear SadieSt,

You are absolutely not alone in your opinion that the traditional breast implants can give a "half coconut" appearance on the chest.  In response to that concern, many of us have started to use shaped implants.  These implants were first developed for use in reconstruction where the goal was to match the reconstructed breast to the opposite natural breast, which is tough with a traditional implant. These are just one of the ways we can ensure a natural result.  By properly sizing and positioning the implant as well as taking into account the soft tissue characteristics of the existing breast, a very natural outcome is possible.  I would look for a surgeon who is comfortable using shaped implants, is board certified, and who you are comfortable discussing your concerns with.  Let me know if I can be of further assistance!  Best of Luck!

Dr. Jespersen

M. Renee Jespersen, MD
Arlington Plastic Surgeon

Pictures would help

Implants typically make a bigger version of what you bring to the table. Show your surgeon pictures of sizes you like. This may influence the style of implant recommended. Hope this helps, good luck!

Marcel Daniels, MD
Long Beach Plastic Surgeon
4.8 out of 5 stars 22 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.