Can I get a teardrop shape from round implants + fat grafting?

Hi Autumn320,
You correctly note 1 of the big differences between anatomic and round implants. Specifically, anatomic implants have an orientation, whereas round implants do not.
Anatomic implants are textured, which provides an external grippiness that minimizes the risk of rotation. In addition, there is an orientation line at the 6 o'clock position which allows your surgeon to place the implant in the correct orientation. These features make rotation less likely.
Fat grafting as a way to add volume, and the natural look that you are requesting requires less volume in the upper pole, not more. As such, fat grafting plus a round implant would not produce your desired shape.
These are excellent things to discuss with your surgeon in face-to-face visit.
Hope this helps.
Best,
Christopher Pannucci, MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

You did not post photos, but you can choose smooth round implants placed behind the muscle. This will give better upper breast fullness, avoid seeing the implant edge, and provide some support for the implant. When standing, all round implants are teardrop shaped. Smooth implants have fewer long-term risks than textured, especially with rotation problems and late fluid buildup, a seroma.

Dear Autumn320,
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