What makes implants look "natural" vs. "fake" for a 5'3", 125 lb. patient? Is 36A to 36C a good target? (photos)

Hi, and thank you for your question. What makes implants look fake is when the implant is inappropriate for your body frame. Patients with a petite frame often have a relatively narrow breast width.  If an implant with too large a base diameter is chosen for such a patient, the dissection of the pocket may have to be carried beyond the lateral boundary of the breast to accommodate it.  This can result in what patients term "excess side boob", i.e., the breast begins to encroach on the anterior axilla, and is visible on the side, when the patient is viewed from behind. This problem was the motivation for developing full or high profile breast implants, so that a given volume can be incorporated into an implant by increasing the implant's projection, rather than its base diameter.  However, at higher volumes, high or extra high profile implants can begin to look a little bit exaggerated, given the anatomy of some small framed patients.The best way to avoid looking fake is to communicate clearly with your surgeon. Your board certified surgeon will take measurements of your body and tell you based on your frame the range of implants you can have. 

Dear Denver00,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

To
change from 36 A to 36 C would require approximately 400 cc’s of fat transfer or
implant.  Your breasts are low on your
chest wall but you do not have ptosis. 
If you undergo implantation, the breasts will appear large and low.  An alternative to consider would be fat
transfers and a breast lift.  This can be
done through a circumareola approach without vertical scars.  It would give you the most natural appearance
since you would be using your own fat.  I
recommend The Bellesoma Method to reshape your breast tissue creating upper
pole fullness without implants, elevate them higher on the chest wall and more
medial to increase your cleavage. 
Vertical scars are avoided, nipple sensation and the ability to breast
feed are maintained.Best Wishes,Gary Horndeski, M.D.