Looking for a Natural Looking Breasts? What Do You Recommend? (photo)

Hello, I’m 31 years, 5’5 and weight 125 32A. And I’m looking to possible get a natural look breast implant with cleavage. I’ve gone to 2 different consultation. The first Dr suggest I go with 475 silicon,under, high profile and crease cut, while the second suggest 425 silicon, under, moderate profile and donut cut! I’m looking for a natural look or something that will not SCREAM FAKE! I’m currently bust 32, waist 28 and 38 I would really appreciate an honest opinion and advice. Thanks!

Doctor Answers 11

Natural Looking Breast Augmentation

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When considering breast augmentation surgery, I believe that the most important question for a prospective patient to ask themselves is this: Am I seeking a natural-appearing result? If the answer is yes, then seek out a surgeon who has the same aesthetic sensibility that you have (and appropriate training and experience). And insist on seeing `before and after' photos. A lot of them 

The actual size of a breast implant, measured in cc's, is really not very descriptive of what a breast augmentation will look like, or what the cup size will be. It is all relative to the size of the breast and the size of the patient preoperatively. A tall, broad-shouldered patient with small A-cup breasts may require 450cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a 250cc implant to achieve a C-cup breast volume.

If a natural appearance is the goal, then the way to get the size right is to 'try out' different implant volumes and profiles in the operating room. Once the implant pockets have been created, sterile sizers can be placed in the implant pockets, and the upper half of the O.R. table raised so that the resulting breast appearance can be assessed with the patient in an upright 'sitting' position (chest fully upright) while under anesthesia. These sizers are available not only for each implant size but also for each implant profile: low, moderate and high (in this practice we use high-profile implants only in rare instances). Inflatable sizers are used for saline implant augmentations, and pre-filled gel sizers are used for gel implant augmentations.

For any patient there is obviously a range of implant volumes that would be considered natural-appearing, and a volume at which the upper pole of the breast begins to look very unnatural. While one patient may seek an augmentation that is 'perfectly natural', another may be interested in a result that is more on 'the full side of natural', and many patients do ask that the largest implant volume be selected that does not produce an unnatural fullness in the upper pole. 

In many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold.

Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).

The horizontal position of breast implants also requires a great deal of attention, both in pre-operative planning and in the operating room. Excessive lateral dissection of the implant pockets will result in augmented breasts with an excessively wide space between them in the cleavage area, and the appearance that the breasts are abnormally far apart. The result may (or may not) be tolerable in the upright standing or sitting position, but when the patient lays down in supine position (on one's back) the implants may fall far to the side and produce little to no anterior breast projection in this position. Patients with the problem almost always want it corrected, and the treatment once again is surgical: a lateral repair of the implant space, to restrain the implants from falling off to the side.

Inadequate lateral dissection, on the other hand, will result in an augmentation with an abnormal 'side by side' appearance. It is lateral projection of the breasts beyond the lateral border of the chest wall (in frontal view) that, along with the concavity of the waist profile and the convexity of the hip profile, produces the appearance of an 'hourglass figure'. While one does not want to over dissect the lateral extent of an implant pocket, careful attention must also be paid to ensure that lateral breast projection is not inadequate.

Breast implant base diameter is also of crucial importance. The base diameter (the side-to-side dimension of the implant) must be ideal for the existing horizontal dimension of the breasts preoperatively, as well as the breadth of the anterior chest in general. Obviously, a given implant volume and base diameter that works well for a small-framed patient that is 5'3" will be completely inadequate for a broad-chested patient who is 5'10". One wants to increase cleavage area fullness and lateral breast projection in most cases, and an implant of inadequate base diameter may accomplish only one of those goals, while too wide an implant will be overprojecting in both directions. Careful evaluation of all of these breast and implant dimension issues is necessary if the ultimate goal of the surgery is a natural-appearing breast augmentation.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Natural Looking Breasts

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Both recommendations are valid and it is not unusual for two surgeons to have a differing opinion. To explore your options, consult with 3 - 4 experienced and expert board certified plastic surgeons and choose the surgeons which understands your objectives and fits your needs the best.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Breast implants

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Both options are reasonable, and it is not surprising that you would get different answers from two different surgeons.  If you go to a third doctor, you may well get a third option.  From your photos, since you do not show the nipple location, I can't tell whether you need a lift at all.  I'm generally not a fan of the donut mastopexy. I have noticed that often the areala gets stretched out and it does not provide much lift anyway. The size of the implants recommended are not that far off from each other.  Either implant will easily make you at least a D cup.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Achieving Natural Look Breast Augmentation

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Achieving Natural Look Breast Augmentation   The most important issue for you is the explain to your surgeon exactly what you expect to achieve with your surgery.  In my practice, in addition to discussing the implant size, I insist that the patients show me with some photographs (my own before and after, or photos from magazines) what do they expect their breasts to look like after the surgery.  Then it’s up to me to decide what surgical maneuvers and what type of implant (size and shape/profile)  to use to to come as close as possible to the patient's wishes.     Without examining and measuring your breasts it is nearly impossible to give you precise recommendations.  Breast augmentation is one of the most commonly performed procedures, but the results not always turn out the way patients envisions, either due to miscommunication or lack of proper skills and judgment on the surgeon’s part.  Make sure that you pick your surgeon well, and communicate with your surgeons completely to avoid disappointment. 

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 62 reviews

Natural looking implants

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I agree that what looks natural means something different to different people.  But most frequently women say that roundness up above or a cantaloupe look, is more "fake" looking.  In my experience this is more frequent with the higher profile implants generally.  The lower profile implants will usually give more cleavage, (less space between the breasts) but less roundness up top.  Bring in some photos of what you think looks "natural" to your board certified Plastic Surgeon for them to look at and compare with their thoughts.  Interesting enough, there is a new implant company, Sientra implants that are only sold to Board Certified Plastic Surgeons.  Good for patients safety, and the specialty!

Dan Mills, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 35 reviews

Natural looking breast with implants

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I understand your concerns about not wanting the "Fake" look. Regardless, of approach (around the nipple incision or inframammary) I recommend you choose an implant that will go under the muscle. High profile, moderate profile, teardrop, etc. do not really matter because your tissues will shape the implant, not the other way around. Another thing you need to consider is the fact that the larger the implant the heavier its going to be and as such the more stretching of your tissues it is going to cause. This means that eventually you will need a lift. I hope this helps you make an educated decision. Best wishes,

Dr. H

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

A Natural Looking Breast Augmentation

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Most women ask for a natural breast augmenation, but this means different things to different people. The implant volumes are on the somewhat larger side and thus, it will depend upon your body, frame and breast tissue on how well this will be hidden and thus look natural. The best means for success with this is open communication with your surgeon and often bringing in photographs of results you would be happy with to help clarify your "ideal."

You should see a board certified plastic surgeon in your area to get a formal opinion through and in-person consultation.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon


Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast implant choice

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Your goal is not atypical: natural, not fake. What I tell patients is that what they have is natural, but they just don't like their breasts or want to "improve" them. What patients usually really mean is they don't want un-natural breasts and this is subject to definition and opinions.. You should spend at least two sessions with your plastic surgeon to establish and communicate what your goals are. Unfortunately, there are many side effects and complications that can make implants appear or act "fake" whether it be size, shape, movement, rippling, visibility, firmness, etc. Your plastic surgeon should review all of these factors and discuss what style, type, dimension, projection, and techniques will give you most of what you consider to be natural. If surgeon and patient are honest, often compromises need to be made. In general, the most natural augmentation will use the lowest profile implant that fits the dimensions of your natural breast.


Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Naturally Looking Augmentation

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I agree with you that a natural look is much preferable to a "fake look".  I cannot tell from your photos if a mastopexy would be beneficial nor the size of implants that you shoulsd select.  I do agree that silicone implants placed below the muscle are most likely to give a natural look.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Natural breast augmentation

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Words like natural and fake mean different things to different people. Images of breasts you like and don't like are far more helpful in communicating your goals to your plastic surgeon.When you see your board certified plastic surgeon evaluate their photos to understand if their aesthetic sense matches yours.The natural appearance is achieved when the appropriate sized implant with the right projection is chosen according to the dimensions of your chest and breast. Technique and placement also contribute to the overall result.If you are unsure of your current options return to speak with your doctor or seek out another opinion.It is difficult to make implant recommendations by photos.Good luck and I hope this was helpful.






Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 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.