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. 

For a natural appearance, you want an implant that fits your breast dimensions, especially the width of your breasts. Placing the implant behind the muscle will also be helpful. Regarding implant style, I would suggest a high profile implant and avoid an ultra high profile. For a very conservative appearance, there is also a moderate profile implant that gives less projection. Good luck!

Hello and thank you for your question and photos. Natural looking breasts can be achieved with breast Implants. The size and shape of the implants can be a large determining factor on whether you end up with a natural result. It is imperative that your surgeon chooses the implant based on your breast and chest wall dimensions to ensure that the implant is sized correctly.  Sizing systems also help in choosing the appropriate implant size. A consultation with a board certified plastic surgeon would benefit you. Best wishes.

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.   

From your photos, you should be able to correct the loss of volume with implants alone. You have a pleasing cosmetic appearance to your breasts, and should be able to achieve a "natural" look if the correct implant size is chosen. A  C cup is certainly a reasonable target. Your breasts will appear the same wether you choose slicone or saline, however the silicone implants will be softer feeling.Provide your surgeon with photos of how you want your breasts to look, and task them with choosing the correct implant for you.

Hi Denver00,
What makes implants look fake is when the implant is inappropriate for your body frame. For example, the same implant in one body type and totally natural in another body type. Variables to consider include how stretchy is your skin? how thick is it? how droopy is your breast? how wide are your breasts etc. The best way to avoid looking fake is to communicate clearly with your surgeon (photos help!) Your board certified surgeon will take measurements of your body and tell you based on your frame the range of implants you can have. Good luck!

A face to face consultation with a board certified plastic surgeon should be very helpful to you. They will examine you including measuring the width of your breasts and other breast parameters. This along with the use of sizer implants and hopefully, 3 D imaging should aid in implant selection.

Hello and thank you for your question. You are a great candidate
for a breast augmentation using a dual plane tehcnique.  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.  This entire surgery
can be performed with a small incision technique.  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

Hello!Sizing is a very important part of the decision process. In my practice, women try on breast implants in a bra to determine what they like most. Under the muscle is a nice way to go. You may want to consider shaped over round implants which will give you lift without upper cleavage - though I do like the rounds to give some fullness - it does look nice.You should schedule with a board certified plastic surgeon and can find one at plasticsurgery.org. Don't skimp on finding the best surgeon you can with whom you feel comfortable. Check out Before and After Galleries on websites - you may find someone who matches your goals.Best of luck!