560(R) and 520(L) full profile look too fake?

Thank you for your question and photos. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (560 versus 520), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest, as you astutely referenced your width to be 12.5 cm. The implants you suggested may well “fit” your breast, but the volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a petite frame will require a narrower diameter implant than a patient with a broader chest or larger frame. Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Your board certified plastic surgeon is your personal expert when selecting the right implant for you. She/He has had the benefit of examining you and discussing your surgical goals. From the photos submitted it appears you will need a lift along with the augmentation for the best result to address asymmetry and ptosis (sagging).

You definitely need a much smaller implant with a breast lift. I would also add Galaflex (for internal support for the breast). Breast implant sizing is based on your tissue based measurements. Based on these measurements (and goal), there is truly only a small range of volume that can achieve a safe, predictable outcome. You would NOT have an adequate outcome with breast implants alone. I would recommend seeing a board-certified plastic surgeon with extensive experience in aesthetic breast surgery.