I Want Implants That Don't Look Fake but Are Still Perky

I've had two kids so at the moment my breasts are pretty much empty sacks on my chest I'm hoping to get implants and go from a saggy 12b to a larger fuller b cup, I've researched a bit on the different looks and have only been able to find the "tear drop" natural look. Is there a rounder type without the bolt on look?

Doctor Answers 11

Round Silicone Gel Implants Can Offer a Full and Attractive Look

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When the breasts have become tear drop shaped naturally or lack volume, breast augmentation may offer dramatic improvement.  I have found that the use of a round, soft silicone gel implant adds to volume in the upper chest better than a tear drop shaped anatomic implant.  Since the upper chest is already deficient and the lower breast contains most of the breast tissue, the round implant gives more upper chest volume and often creates a rounded teardrop look as the end result.  Round implants also avoid problems with implant rotation.

Los Angeles Plastic Surgeon
4.8 out of 5 stars 34 reviews

Round Implants Become Tear Drop If Properly Placed

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Tear drop implants are to be avoided because:
1.  they have a tendency to rotate and no one likes a diagonal breast.
2.  all teardrop implants are textured and textured implants do not give the soft breast feeling.  I personally believe we will hear more negative comments about textured implants in the not too distant future.
Round implants, if placed partially subpectoral, routinely give a tear drop appearance because the muscle pushes on the upper two-thirds and the lower one-third is outside the muscle as seen on lateral mammogram. 
I personally prefer the high profile implant because I believe it gives the most natural breast-like appearance, both perky and not phony looking when in the partially subpectoral space. 

Choosing the right implant

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Choosing the right implant so that you can obtain the best look is performed in the office during consultation.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

What size implants?

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Implant size should be selected based on the your goals and dimensions. A combination of implant and breast lift might be the right choice to correct the amount of sagging that you describe. Go get some consults.

Breast implant size selection

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I consider two factors when selecting implants for my patients:
1.Dimensional planning
2.Gel Implant Sizing system
Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.
Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for.
This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.
Hope this helps.

Shape of breast enhancement result

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I believe it is important to communicate to your plastic surgeon what type of shape you would like to achieve.

Some women start with a large amount of natural tissue and no matter what type of implant is used, they will never achieve the fake round look.

Some women start with anatomy such as a wide chest or widely separated breasts which precludes them from having the result they desire.

It is important that the plastic surgeon understands each lady's goals and is able to communicate to her what is technically achievable for her.  Each patient is different, and no two breasts will respond to surgery exactly the same way.

Yes, there are different shapes and styles of implants and thus we need to understand the look you are seeking.  Then, after seeing your breasts in consultation we should be able to give you realistic expectations of potential outcomes.

Good luck!


Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.8 out of 5 stars 77 reviews

Achieving Desired Look with Breast Augmentation?

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Thank you for the question.

As you can imagine, it is not possible to provide you specific advice for your situation. However, generally speaking there are a variety of different “looks”  that can be achieved for any specific patient. A full communication between patient/surgeon is critical to determine exactly what the patient is trying to achieve. In my practice, the use of goal pictures is very helpful in this process.

For example, patients may demonstrate breasts which they find attractive as well as  breasts that  they feel are too big or too small...  Furthermore, patients can communicate their goals in regards to an overall “look” they are trying to achieve.  For purposes of providing a clear answer I will  summarize the 3 most common "looks” that patients are trying to achieve with breast augmentation surgery.

1. Some patients wish to have as “natural” an appearance as possible;  these  patients may demonstrate their goals with pictures of breasts with minimal to no superior pole volume ( teardrop shape or gentle ski slope shape).  These patients will typically tell me that they prefer other people not to know that they have had the procedure performed. They also tell me that if they wish to have superior pole volume/fullness they will continue to use a push-up bra.

2. Other patients may demonstrate their goals to be “full, round, fake looking breasts”. Obviously, the pictures that these patients choose to demonstrate their goals will show very round, “unnatural” breast examples. These patients often tell me that they do not mind if others know that they have had the procedure performed and do not want to wear a bra to achieve these superior pole volume/fullness.

3. Another group of patients tell me that they wish  to achieve a “look” somewhere in between the above 2 groups. In other words, the patients will demonstrate their goals with pictures that show some “gentle  roundness” along the superior poles of the breasts. These patients will often state that they wish to have some volume/wellness without the need for push-up bra. I call this look a “keep them guessing” look. In other words, a stranger may not necessarily know that the patient has had a breast augmentation when she is wearing a tank top or  swimming suit. Yet, she will not have to wear bra to maintain some superior pole volume.

The best advice I can give two ladies who are considering breast augmentation surgery online 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're 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 if communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

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.

I hope this helps.

Perky implants

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You may find that an implant with a smaller base width to make your breasts project more forward from your chest wall and body can be sufficient, making a breast lift unnecessary. Consider the Allergan Inspira TruForm 2 implant and an areola reduction.

Retro-pectoral SIlicone with Mini Ultimate Breast Lift

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The best implants are silicone gel placed retro-pectorally.  They have the most natural look and feel and the retro-pectoral provides maximum padding.  You describe your breasts as empty sacks, so you do not have much breast tissue overlying the muscles.  It may be necessary for you to undergo a lift at the same time.  This can be done through a circumareola approach, leaving only one scar around the areola.  I recommend Breast Augmentation with Mini Ultimate Breast Lift which will place the implant, elevate your remaining breast tissue higher on the chest wall, increase upper pole fullness, elevate the areola and give you a natural look without vertical scars.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Fake, natural, and perky

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One of the problems is defining what looks "fake", "natural", or "perky" to you. 

Breast implants are just pillow volume behind the breast. They don't lift the breast, tighten it, or move it around. Your skin tone, tissue tone, and general characteristics are not changed by an implant. 

To my way of looking at it, "fake" means that it looks obvious that there is an implant present. "natural" means that the breast does not look as if it has an implant behind it. "perky" is a youthful looking natural breast. 

Naturalness requires that the implant be sized properly, positioned properly (including behind the pectoralis muscle for the upper half of the breast), filled properly (if it's saline), and then healed properly. The vast majority of breasts for cosmetic augmentation don't need a "tear-drop" shaped implant and, in fact, experience has shown multiple drawbacks to this type of implant in cosmetic augmentation. 

The minimum size increase with a properly fitted and lowest profile implant is about one cup size relative to the breast size started from and in the same chest circumference. The maximum size is about two cup sizes. High profile implants can look less than natural because of excessive projection in the upper pole of the breast although this is becoming more acceptable even though it can be avoided. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.