I'm looking for natural looking & size DD breasts cup. I don't want to see the outline of the implant. Any suggestion? (photo)

Question

Hello I'm 5 ft 3 and weigh 110 lbs. I wear a 34 b bra at present and had 3 children who I breast fed. Iv been told I'm an ideal candidate that I have enough tissue to go ON TOP OF THE MUSCLE. I'm always reading about implants being placed under the muscle for a natural look. I want a natural look but good size breasts. He's recommended 360 cc silicon will this give me good size breasts without seeing the outline of the implant if on top of the muscle

Paul Vitenas, Jr., MD · Answer

Judging from your height
and weight, a DD breast and a ‘natural looking breast’ do not go together.  A breast that looks natural must be
proportionate with a woman’s body frame, so for someone who is 5.3” and 110lb,
this will not be a size DD.  Looking at
your photos, a 360cc silicone implant would give a very nice, natural looking
breast.  Placing the implant under the
muscle would give you more upper pole coverage, as well as provide a more
natural, sloping result.

Gary Lawton, MD, FACS · Answer

Submuscular implants would give you an excellent result.  There are many disadvantages to over the muscle.  The 360 cc implants will not make you a DD

Michael Brucker, MD · Answer

Based on your photos, while you do have a good amount of tissue for coverage, placing implants over the muscle lends itself to a more unnatural look, much like Pamela Anderson.  There is also a much higher risk of developing capsular contracture when implants are placed over the muscle.  If this happens, the fix for it would be to remove the excessive scar tissue and then reaugment with new implants placed under the muscle.  If your goal is to have the most natural look possible, you should consider placing implants under the muscle.  The muscle will help hide the roundness of the upper portion of the implants.  You may also be a candidate for shaped implants which tend to look even more natural, especially considering the large size you want.  I have found Vectra imaging to be very useful to help patients visualize what various sizes and shapes look like on their frame.  I think it is important for you to understand that going from a B cup to a DD cup on a very small frame will lend itself to an "implanted" look to some degree.  A surgeon can do some things to minimize the unnatural look but you also need to have realistic expectations.

Alejandro Nogueira, MD · Answer

The latest trends and the technique I am using the last 6 years is the subfascial plane, recommendably with anatomical shaped implants, the results a superb and the procedure minimally invasive, less aggressive and with safer rates of postop complications; needless to say the recovery is smoother quicker.

Kenneth Hughes, MD · Answer

If you do not want to see the implant, a submuscular augmentation with a reasonable sized implant is probably better.  I
would search for the board certified plastic surgeon who you feel is
most likely to give you the best results and who performs hundreds of
these procedures each year. I would look at patient reviews as well as
before and after photos on that surgeon's website.Kenneth Hughes, MDLos Angeles, CA

Alex Campbell, MD · Answer

Breast augmentation is a very powerful technique in the right hands, and can have dramatic results in a variety of breasts types.  Size is a tricky question for many women who choose breast augmentation.

There is an ideal shoe size for your foot. Too small and your foot will be crammed and too large and your foot will not fill the shoe. The same thing is true with breasts: too large and it will look round and fake; too small and it will be loose and empty on the top.

The common denominator to the most beautiful breasts is that they were sized objectively on the basis of measurements.  We combine a proven formula based on measurements of the rests and chest along with through discussions of patient's desires.  Photos of ideal breasts and results from patients with similar breasts are often very helpful in the discussion.  A rice test in the office or at home can also be very helpful. The key is to work with a Board Certified plastic surgeon with expertise and experience in breast augmentation.  Don’t settle for less!

Ronald Levine, MD · Answer

A DD cup size is quite large and at your height and weight, it may not look natural. But if all you're concerned about is not having a visible outline of your breast implants, then it may be possible. However, I'd suggest going under the muscle because the size you want is large. You'll most likely need the additional support and coverage.

David S. Chang, MD · Answer

You should be able to achieve a natural, full look with either subglandular or subpectoral implant, but that size may or may not be a DD bra cup.  It's difficult to say what size implant would be best for you without examining you in person and determining the dimensions of your breasts.

Tom J. Pousti, MD · Answer

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal. You are starting at a good place.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.  4. The size and profile of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” or "fake looking" etc can be confusing...
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
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.
 I hope this, and the attached link, helps.

Christopher D. Knotts, MD, FACS · Answer

Thanks for sending photos, they really help. The main determinant of how well the top of the implant hides is how much tissue you have. The more breast tissue you have, the better the implant can hide behind the tissue and not be seen. The best way to check for 'adequate' tissue is to feel in-person, though from your pictures I wouldn't be surprised if you have enough. That being said, hiding it under the muscle would be even less visible in terms of the rounded upper part. Even better than that might be a shaped implant where the top isn't round and doesn't look as fake. Hope that helps!CDK

I'm looking for natural looking & size DD breasts cup. I don't want to see the outline of the implant. Any suggestion? (photo)

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