What kind of breast implants look the most natural?

Question

34 years old/5'4"/106 lbs. 32 AA. I want implants that don't look like implants if that's possible? I know there are various kinds and alternative procedures like fat transplants. I want them to be just big enough for clothes and swimsuits to fit well. The top of my shirts constantly slide down leaving my bra showing as my breasts aren't big enough to hold them up even in padded bras. What makes implants look most natural? A small increase to still fit my frame? Implant type? Surgeon skill?

Ali Riza Öreroglu, MD · Answer

I prefer to choose implants together with my patient during the preoperative examination. My preferred implants for natural-looking breasts are ergonomix implants. They mimic the natural breast tissue and move with it. So, when you're standing, they stay in a teardrop shape, and when lying down, they maintain a round shape. Sometimes I may decide to go for a hybrid surgery, involving breast augmentation with implants and some minimal fat grafting to conceal the transition of implant in the patient.

Leland Deane, MD, FACS · Answer

A very natural result can be achieved with the right implant size and pocket dissection. The exact type of implant is less important but I think that most of us feel that 'shaped' implants are not necessary and round smooth implants give a very natural result and look. My patients' friends do not know that they've had implants. Happy to discuss and show you results via a virtual/telehealth consult.

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
With regards to your specific question, the best way to achieve a "natural" look is to respect your unique anatomy and measurements. Careful selection and planning is the most important factor.
As always, discuss your concerns with a board certified plastic surgeon.

Donald Groves, MD · Answer

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this: 
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you. Also, just FYI, each surgeon's measurements are slightly different, so numbers, experience, and overall aesthetic from one surgeon aren't necessarily the same as those from another surgeon!

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Daniel Barrett, MD · Answer

Dear Meli.09,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Chet Mays, MD · Answer

Breast implants are a great surgical option if you're looking to add volume to your breasts. The most natural results will be achieved by adding a small implant proportional to your body underneath your breast muscle. I would recommend scheduling a consult appointment with a board certified plastic surgeon like myself to discuss the best treatment/surgical plan for your desired goals.

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your question,

The naturalness of breast implants depends on various factors, including the type of implant, the surgical technique, and the individual's body characteristics.
Choosing an implant size that is proportionate to your body frame is crucial for achieving a natural appearance. Going too large may result in a less natural look.

Kind regards,
Dr. Emmanuel Mallol

Leila Kasrai, MD, FRCSC · Answer

The skill of the surgeon would probably be the most crucial factor in achieving natural looking results. They will help you choose a suitable implant size and type, based on your body dimensions and goals.

Azita Madjidi, MD, MS, FACS · Answer

in terms of feeling, silicone implants feel more like normal breasts than saline implants. In terms of shape, the lower profiles will give you a nice fullness and High Profile will give you the unnatural "push up bra" look with the roundness on top even without a bra. You need to see a board certifies plastic surgeon and discuss your options based on your particular measurements.

Gary M. Horndeski, MD · Answer

At size 32, each 100 cc of implant corresponds to 1 cup size change. From this, you can determine the volume required to achieve your desired goal. The most natural feeling implants are retro-pectoral. Silicone implants feel more natural than saline implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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