How to Get Natural Saggy Looking Breast Implants? (photo)

I think that you could achieve the result you want by switching to a moderate plus profile implant instead of a high profile. Also, if you want a little more fullness on lower pole than the upper, you can have the inframammary  fold lowered slightly.

I don't think you can tell from a photograph or do the implants are above or below the muscle. To me the breasts appear artificially supported which occurs of capsular contracture. Dealing with the contracture is the best way to get a natural look.

Result looks very good for your body type. Maybe fat grafts would increase the size and keep a "natural" look. 

While I agree with most of my colleagues who have responded here that you have what most might consider a "nice result," to you it is not what you really want.  Thus, I think it is reasonable to explore options to change your breasts if that can be done safely and rationally and it has a reasonable expectation of producing the results that YOU really want, no matter what anyone else has to say.  If I understand you correctly, what you are really looking for is more fullness in the lower part of your breasts, that is, you would like more show of the breast fullness below the nipple and areola.  I agree with you.  I also take it that you want your breasts to be a bit larger too.  You currently have 325 cc implants over the muscle, and although we don't know your height and weight, I can say that those are relatively modest sized implants, especially with the dimensions of high profile implants.  If you are looking for something like Kim Kardashian or Sofia Vergara, those probably won't get you there.  I also understand that you would like a more "natural appearance," and this to me means less of a round, full look on the top of the breasts.  Your existing implants are above the muscle, and high profile, and this is working against that.  So, what would I do instead?  I would remove your existing implants along with the capsules surrounding them, and I would extend the pockets for the implants slightly lower and toward the outside to produce just a little more fullness of the breasts in those areas.  Your nipples are slightly pointed down and out, and that is because your implants are too small and narrow and not placed optimally.  In addition to this change in placement of the implants I would also replace them with slightly larger moderate plus profile implants, perhaps 375 cc or 400 cc.  I would also change to a submuscular placement on top to cover the top of the implant and soften the contour and give you that more natural look.  I would have no reservations about doing such an operation on a lady with your appearance, and I would be confident that it would achieve the goals that I have mentioned.  You should have another consultation with a board certified surgeon who has a lot of experience in revisional breast surgery and can think this way, and allow him to advise you more completely about your options.  Suffice it to say that I see why you are not happy with your result even though others may think that it is good, and if you are not happy with the result, then I think there is reasonable expectation that it can be improved for you.  Good luck. 

Based on your photo, it appears you have a very nice result.  Your PS is correct.  There are some limitations of what can be achieved given your skin quality and anatomy.   Shooting for a "movie star's" breast shape simply may not be reasonable or achievable.   And remember, you've got a good result.  Trying to make changes to your result could open up pandora's box.   Best wishes.

Dr. Basu

Houston, TX