What is most natural breast augmentation to get it as big as this? (photo)

Hello and thank you for your question and photo. The most natural appearing augmentation can be performed by fat transfer in which fat is harvested from another area and placed into the breasts. However, you will not be able to achieve the size you are showing in the picture without an implant. It is best to make a consultation with a board certified plastic surgeon to discuss your goals and concerns. This is the only way to determine what would be  the best size for you. Best of luck. 

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon