What Determines the Shape of the Breast After Augmentation?

I have seen hundreds or even thousands of "before and after" pictures of breast augmentation cases. The thing that confuses me is that I'll look at two pictures of people with NO breast tissue.. both get the same size implant... one ends up with a "ball under a blanket" and one gets breasts that look like natural grown. Both might be "unders" Both might be "overs"... that doesn't really seem to make a difference... What DOES make the difference?

Doctor Answers 8

What makes the breast shape after implants?

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You're right, every patient has a different skin type and heals a little bit differently. The surgeon makes the difference. Only he/she can recognize what each patient requires to get the result you want. Flat chested patients can get big full voluptuous breasts but not instantly. It takes months of massage and waiting for the skin to grow, but it will and a natural shape can result. Patients with small saggy breasts need both excess skin excision and implants to get a youthful shape. It's two operations. The surgeon is the one to choose the implant tyoe and the placement (under or over the muscle), not the patient. Your job is to communicate to your surgeon exactly what you prefer and it's his/her job to deliver that result with whatever combination it takes.

Dr Foster Lake Tahoe Plastic Surgery

Sacramento Plastic Surgeon

Implants DO NOT reshape breast tissue, Mini Ultimate Breast Lift DOES

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The final appearance after breast augmentation is mult-factoral.  It depends on the amount of breast tissue you have, skin tone, where the implants are placed (in front or behind the muscle), whether there is breast ptosis, breast position on the chest wall, cleavage and symmetry.  An implant alone does not produce a beautiful breast.  Many people focus on implant size when other factors are essential to produce breautiful breasts.  The Mini Ultimate Breast Lift reshaped the breast, elevates the position of the breast on the chest wall and increases cleavage.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Shape of the breast after augmentation

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You have made a brilliant observation that shows you have a very keen eye. Yes no person looks exactly like the other even when all of the factors are the same. The style and size of the implants are most important for the final look if the sizing is appropriately done. 

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Breast shape after implants

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The final shape of the implants and how they look on the chest for each individual patient is multifactorial.   It can depend upon the skin quality, the pocket location, the amount of breast tissue present, the size of the implant, to name a few.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast shape after augmentation is determined by several things!

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What looking at hundreds or thousands of breast augmentation "before and after" photographs cannot provide is the medical history and physical examination (measurements, skin tone, muscle tone, weight gain and loss, childbearing and breast-feeding history, evaluation of the chest wall, etc.) that are the routine parts of a detained consultation with an ABPS-certified plastic surgeon experienced in breast enlargement surgery.

In general, the shape of the breast is not changed by enlarging it--each patient simply gets a bigger version of their pre-operative breast shape. Of course, there are indeed women who have very little  of their own native breast tissue, tight skin and firm musculature, and have never been overweight, had babies (or breast-fed), and therefore will have a firmer, rounder result, especially with large(r) implants compared to the "capacity" of the containers!

Then there is the woman who is older, has poor tissue elasticity, weak or thin muscles, has gained or lost weight (in her breasts also), or who has breast-fed one or more babies! Especially if this woman chooses conservative breast implant sizes, she will have a more "mature, natural, or tear-drop shape" appearance. Severe cases may even need breast lift (skin tightening and shaping incisions and scars) in addition to implants.

So, as you can see, EVERYTHING makes a difference! How much each of these contributing factors plays a role is something that each plastic surgeon must assess and decide upon in consulting with their patients. An expert can even give you an idea as to what you might look like after surgery, with your individual characteristics and unique goals. That is why we always state that goals can "usually" be met, if your anatomy cooperates!

But you cannot hand even the most talented balloon inflater a balloon shaped like a horse, and ask him to blow it up so you get a kitty cat! With few exceptions, the same is true for breasts. Implant choice, position above or below the muscle, proper muscle fiber release and pocket positioning to take into account softening and dropping over time, and accurate implant positioning, not to mention avoidance of capsular contracture, symmastia, "bottoming out," double bubble, etc. are all things your surgeon needs to consider and address. BTW, most revisions are for size (too small), next for malposition, and lastly for capsular contracture. Other issues can require re-operation, but they are rare if you choose a skilled and experienced surgeon in the first place!

Thanks for your question! For more information, click on the web reference link below. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Factors Impacting Final Breast Shape

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This may be one of the best questions I have seen on RealSelf, and cuts to a fundamental issue of breast augmentation surgery.

There are two key elements that impact the final shape of the breasts after augmentation surgery: the implants and the breast. While this may seem intuitive, the interaction between these two elements may not be. We must never underestimate the importance of the native breast shape- this is probably the most important element in determining final shape.

In essence, the larger the implants or the tighter the native breast, the more round (or "augmented") the final result will appear. This is because a tighter skin envelope (especially smaller breasts or woman who have never breast fed) will not stretch as well and the implant will be the primary determining factor of the final shape- most implants are round. A "large" implant will have the same effect. Describing an implant as "smaller" or "larger" is relative, but this is why higher profile implants tend to look rounder in many women.

Conversely, in the situation of a "smaller" implant or breast tissue that is more elastic (stretchy), the implant will be less of a determinant that the native breast tissue giving what many people call a more "natural" look. Pocket choice can impact the final shape as well, but is usually a minor factor.


Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Breast Shape After Augmentation #breastimplants

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This is a very loaded question that I spend an hour going over in my consultations with patients. Shape can be determined by the style of implant you obtain, what your breasts look like before surgery and many other factors such as pocket choice. You will really need to get most of your answers at your consultation. Keep in mind when you see your surgeon, breasts usually end up sisters not twins. Most women start out with asymmetry and this will be augmented after implants are placed. It becomes even more noticeable. One nipple might be slightly lower than the other. One breast might be slightly bigger. If there are large differences some patins need the nipple moved on one side, or even different volume implants in each breast to try and make things more even. Seek a board certified Plastic Surgeon. This is the most important thing along with having a trusting relationship with that person. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Breast shape after augmentation

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The most important factor in determining your shape after augmentation is the shape of your breasts before surgery as implants magnify who you already are.  Beyond that placement below or above the muscle and the chosen profile of the implants are key.  Finally the eye, talent and artistry are vital.

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.