Will high profile 225cc over muscle look good on me or give me a fake look? (Photos)

Question

I want a natural augmentation without an obvious upper pole and my PS sugested between 200cc and 250cc Mentor round gel and advised me on 225cc. I want moderate + but according to my breast width my PS said only 200cc moderate + would fit me and I think 200cc will be small. If I want 225cc it would have to be high profile. I'm afraid I'll look fake, and I'll have a gap between my breasts. I'm 5'7 and 125 lbs, ribcage width (under breasts) is 28.34 inch and my chest width is 32.28 inch. Thanks!

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
The size of implant is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.
  
Silicone will give you a fullness at the top (upper pole fullness).
  
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
  
Anatomic gummy bear implants might be a good choice to give you volume.
  
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
  
The best way to assess and give true advice would be an in-person exam.
  
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Aldo Guerra, MD · Answer

Hi Sophia S.S.Have you considered gummy bear tear drop shape implants? These are certainly more natural looking than a round breast implant. The size you have chosen will likely look more natural than a bigger breast implant, but I cannot tell for sure online.Best wishes, Dr. ALDO :)

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. It appears you will achieve an excellent result with implants in the 200 - 250cc range. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Tom J. Pousti, MD · Answer

Thank you for the question. 
 Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.Make sure you also carefully consider,  the short and long-term pros/cons associated with breast augmentation done in the sub muscular versus sub glandular position. You will find a lot of information regarding this topic on this website.
I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 
On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle) that can be seen with breast implants placed in these sub muscular position. There are several steps taken to select a specific size/profile breast implant for a specific patient.  I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
Ultimately, careful selection of plastic surgeon and careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, 
I have found that the use of words such as “natural or fake” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
In your case, my best advice: more communication. It will definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
I hope this (and the attached link/video, dedicated to breast augmentation surgery sizing concerns) helps. Best wishes.

Brooke R. Seckel, MD, FACS (retired) · Answer

In my experience, the high-profile breast implants look very natural and almost always achieve an excellent result.  However I believe your interest will be better served with the implants placed under the chest muscle.  To learn more about achieving a natural looking breast augmentation please read below:

Will high profile 225cc over muscle look good on me or give me a fake look? (Photos)

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