Is it possible for breast implants to create a swooping or slopped breast with puffy nipples?

Doctor Answers 7

Natural look possible after breast augmentation?

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Thank you for the question.  Online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, 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, and computer imaging) will be critical. 

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. 

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. In other words, 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 model 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” etc

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.

 I hope this, and the attached link (dedicated to breast augmentation concerns), helps. Best wishes.

Breast augmentation

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Hello and thank you for your question. It really depends on your pre-operative breast anatomy.   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.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

Breast implants

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A natural look is achievable with proper implant size, projection, etc selection for each patient's particular situation. In some cases, a breast lift may be also required. I am not sure what you mean by puffy nipples.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. 


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Reviewing your goals in person is key. You should bring some photos to show what you are trying to achieve.  

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

Is it possible for breast implants to create a swooping or slopped breast with puffy nipples?

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A swooping or sloped natural looking breast with fullness beneath the nipple areola is a goal that is achieved in most patients are in proper breast augmentation techniques and normal healing occurs in most patients with most types of implants.  Shaped textured implants are used to accentuate this shape however textured implants to have some limitations.  Your most important choice is your choice of a board certified plastic surgeon who is very experienced at breast augmentation surgery.  Be sure to discuss your goals in detail.  At a recent meeting of a group of board certified plastic surgeons with experiencing cosmetic surgery, a survey revealed that 83% of these plastic surgeons used smooth round silicone gel breast implants.

Sloping implants

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Thanks for your question. Silicone implants tend to take on a more sloping or tear drop shape when in the body and under the muscle. Saline implants are more like water balloons so they have more fullness up top so less sloping.

There are implants that have a teardrop shape to begin with (gummy bears). These have a thicker silicone and a rough surface so they stick inside and don't rotate inside you, but sometimes they can.

In general  implants do not create a puffy nipple, although in some cases the nipple may project more.

Any natural sloping can be lost if the implant is too large. For what you seem to be implying I tend to favor a smooth round implant ( doesn't matter if it rotates), common sense size, and under the muscle.

Hope this helps.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Breast augmentation outcomes

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Without a photograph, it is impossible to tell you anything about your specific situation. However it is very possible to create a natural appearing impressed limitation procedure.The key is communication with your surgeon to ensure that they are aware of your ultimate aesthetic goal. If you have an issue related to a constricted breast, That would need to be addressed at your consultation.

You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.

Best of luck,

Vincent Marin, MD

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

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.