Does Implant "Style" Make a Difference in Appearance? (photo)

I wanted full breast near the ribcage & was naturally large but lost volume in that area. I didn't want projection. I was told I needed 450cc. Woke up with Natrelle, style 20, 375cc. I'm 12w post op and hated my look since 8 weeks. They have NO volume on the sides are too pointy & nipples are off more than before. PS states he gave me moderate, Natrelle states they are HP according to the serial numbers. I've been calm and patient with PS but he wont call. How do I get the desired look?

Doctor Answers 20

Style 20 is a high profile implant

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Hi SMP1996,

The style 20 implant is a high profile implant.  For a given volume, a high profile implant has the narrowest width.  It appears from your pre-operative photos and given your desire for width, that a mid-range (Allergan style 15) or moderate profile plus (Mentor) might meet your needs.  The most important thing is to know the width of the base of your breast (pre-op measurement).  This can help the surgeon select the right implant for your breasts dimensions and, knowing the look your desire, one can select the proper style implant.  If you have more width on the outside of the breast, the nipple will look more centered on the breast mound.  However, keep in mind that on your pre-op photos, the nipple appears to be lateral (off to the side.  You were made this way and it is OK.  Adding a little more width to the breast can help camaflouge this.  Consult with your plastic surgeon and discuss these issues.  I am glad that you are staying calm and reasonable; you will be much more likely to achieve your goals by working with your plastic surgeon. 

Tracy M. Pfeifer, MD, MS

Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Breast lift generates more projection than implant style

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Your history of volume lose and photographs show that your breasts have descended on your chest wall.  The most important aesthetic factor will be lifting the breasts NOT the style of implant.  Your goal photograh shows breasts high on the chest wall with nipple centered over the mound.  Your after pictures show the implants low on the chest wall with nippoles on the inferior and lateral.  You will need a circumareola approach for capsule plication to elevate implants.  Then your remaining breast tissue is elevated and your nipples centered.  All 3 must be aligned in the same horizontal plane to achieve your desired goal.

Best of Luck,

Gary Horndeski, M.D.

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

Unhappy with breast augmentation results

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The implant style definitely can make a difference in the outcome from surgery and this can be both a positive or a negative. If such wasn't the case, there would be no need for the categories of low, moderate, high and even super-high profile implants.

With your pre-operative anatomy, it is an impossibility to obtain the goal photo results. Whether your situation resulted from a lack of communication, unrealistic expectations or ignoring of the information can't be known in a forum like this. Your best course at this point would either be to return to your plastic surgeon and discuss options or seek a second opinion from another board certified plastic surgeon.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

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Does Implant "Style" Make a Difference in Appearance? (photo)

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The posted self photos appear as a too small implant was chosen. I agree with 450 or 475 HP. But as for achieving the third photo look, you can not because of the genetic location of your N/A complexes. Realistic expectation are very important and possible results should have been outlined in your pre operative visit. If so unhappy discuss with your chosen surgeon or seek second opinions. 

Breast augmentation -getting it right the first time

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There is no implant or surgeon on this planet that/who could get you from your before photo to your goal photo by just placing breast implants. First, your goal photo is not optimal because the left breast fold and implant are situated significantly lower than those on the right. Second, Your before photo shows divergent breasts (nipples point outward) with most of the breast tissue at and above the nipple line while the goal photo breasts have both nipples facing forward and the breast tissue evenly distributed around (above and below)the nipples. I cannot see anyway to make those more alike by just placing an implant in each breast. What you see in your after photo is just magnified visibility of the divergent breasts/nipples and breasts at/above the nipple line level. If you decide to revise the breasts you need to have a full discussion with your surgeon even if it is the previous surgeon of your current condition, what you want and what is acheivable by specific surgical techniques. You will not be able to get exactly what you want no matter how aggressive the surgery and more aggressive surgery will just leave you with more scars.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Implant style

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I am sorry to hear that you are unhappy with your postoperative result. We take our patients as we find them, meaning that if your breasts have a certain shape preoperatively, surgery cannot take you from your breasts and make them look like someone else's. In your case, your nipples are low on the breasts and point laterally. A lift/augment might have produced some improvement. I recommend that you make an appointment to see your plastic surgeon to discuss your concerns and also to remember that your healing has a ways to go.

Breast augmentation alone made your breasts bigger.

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Thank you for your question and I understand your frustration.  Thank you for the photos.  Yes, in the before picture you have some extra skin, volume loss, and laterally pointing nipples with large areola. In the after picture these characteristics haven't change and are magnified by the implants. 

In order for you to get the look in the Goal Photo, a couple things have to happen.  One is you will need a larger, wider implant if you like the look and want some breast volume on the sides. The other thing that needs to happen is to have some of your extra skin removed by a circumareolar mastopexy to slightly lift the nipple, bring it into a more central location on the breast mound, and decrease the areolar diameter.

Without doing these things, it is impossible for you to be close to the Goal Photo you show because the person in the goal photo I imagine (preop) did not have extra skin, volume loss, or laterally pointing nipples with large areola as you did.

When a women chooses to undergo breast augmentation with the placement of implants only, then the result will be your breasts bigger unless other things are done to fine tune the result and adjust the breast shape and nipples to get the result that you desire. That is exactly why showing pictures of other women's results can be misleading or give the hope of unrealistic expectations. 

You can get a different result. You will just have to be willing to have more done either all at the first surgery or now that it's done, have nipple position revision with areolar reduction and wider, maybe larger, implants.

I hope this helps. Best of Luck!


J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 221 reviews

Natrelle style 20

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The implant you are wearing is a high profile breast implant. The implant style affects the diameter and projection and therefore will change the 'look' of the breast. If your surgeon will not talk with you, you will have to see another to get things sorted out.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Does Implant "Style" Make a Difference in Appearance? (photo)

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I believe you and your surgeon have not communicated well.

As I have observed in other cases we're talking about surgery and not magic.

The appearance of your breasts after surgery depends directly on how they look before surgery. Only a magician could allow you to look like the person in your goal photo.

The surgeon's task is to help patients to understand this and to develop realistic expectations. Next, he or she must do all they can to make the most attractive breasts from what the patient brings to the operating room.

One of the keys to a satisfied patient is the avoidance of surprises. I always strive to agree on the size and profile with the patient preoperatively, so they know what to expect on awakening after surgery.

I hope you can get satisfaction from your surgeon. If not seek out an experienced and understanding board-certified plastic surgeon in your community.

Good luck!

Breast augmentation goal

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Many patients bring in photos illustrating their goals for breast augmentation.  As everyone has a different shape, it is always important to point out these differences.  The goal photos in your post seem somewhat unrealistic given your preoperative photos.  An augmentation/mastopexy may have helped, however, even this may not lead to long term upper pole fullness and can also introduce contour irregularities and additional scarring.  IT is important to establish effective communication with your plastic surgeon to ensure realisitic expectations and a good outcome.  I would suggest followup with your plastic surgeon to address your specific concerns.    

Stephen Delia, MD
Boston Plastic Surgeon

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.