Round v Tear Drop Implants for natural appearance. Petite build 5'5. (photos)

In the process of attending consultations before choosing a surgeon for breast aug. I've seen 2 surgeons so far & both have very different advice. Currently 34A and would like to be a size 34C (natural looking) Surgeon 1 rec. round implants between size 240-280cc. Surgeon 2 recommended tear drop size 350cc (both over muscle) I have a no. of fibromas. Surgeon 1 wouldn't remove them due to potential risks. Surgeon 2 could remove the larger ones during surgery. Any advice would be welcome

Doctor Answers 8

#Breastaugmentation #BreastAug #Implants #Breastimplants

Hello Rose031,Thanks for your question on which implant size would be best for you.  Since there is no way to say definitively over the internet which size would be optimal for you, take comfort in the fact that the surgeon uses your unique measurements and is able to provide you with a general range.  In many cases the board certified plastic surgeon can best be your guide as they’ve met with you in person and heard your aesthetic goals. You may consider doing 3-D imaging; however with nearly all the breast cases we’ve performed, we’ve found patients enjoy doing a live “try on” session where they actually can “try on” the implant in a non-padded bra in our office.  This does not give an exact measurement of outcome, rather it gives a nice idea of what to expect. For patients who desire a more natural look we like to recommend the shaped implant.  For patients who desire a more full, voluptuous look we recommend a higher profile implant. And remember that all breasts have at least some amount of asymmetry (we like to say they’re like sisters and not twins).  My very best to you, Brian S. Coan, MD, FACS

Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 63 reviews


From your pictures, I think standard round implants will provide a very nice result.  A larger implant can be used for the left side to even sizes out.  You already have breast tissue and symmetric shape so anatomical implants are not really necessary.

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 26 reviews

Round v Tear Drop Implants for natural appearance.

You appear to be a good candidate for breast augmentation. With the superior hollowing of your breasts and thin tissue I would recommend round implants placed under the muscle. This will give a natural "flow" to the implant as native breast tissue looks round when laying flat and tear dropped when standing. Round implants will do this. Anatomic or tear drop implants will always have the same same shape regardless of position and can shift months or even years after placement.

Implants on top of the muscle in your case will likely show visible rippling where the submuscular placement will give an added buffer of tissue to eliminate this rippling in the upper part of the breast.

I realize this is confusing, but find a surgeon with whom you feel comfortable and has photos of results of his/her work that you like.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 13 reviews

Round v Tear Drop Implants for natural appearance.

Thank you for the question. Based on your photographs, I think that you are starting a good place and should have a very nice outcome with breast augmentation surgery, regardless of whether you use round or "anatomic" breast implants, assuming you choose your plastic surgeon carefully and communicate your goals carefully as well.

These days there are a variety of breast implants available; the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally (again), I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).

Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) 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 are 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 communication will be critical in determining 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. For example, I have found that the use of words such as “very natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. You will find a separate page, on the same website, dedicated to breast augmentation for petite patients. Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 81 reviews

Breast augmentation round vs shaped implants

Thank you for your question.

During your consultation I like to find out your goals(i.e. What cup size you would like to be ).

Its important to measure the width of your breast to determine which implant you need. There are four different profiles of round silicone implants. They are moderate, moderate classic, high and ultra high profiles.

Shaped implants also also come in different profiles. Both implant types would work well with you. It depends what your goals are. The shaped implants are firmer . They give you a more natural superior slope to your breast. The round implants are softer and give you more fullness on top.

I go on top of the breast muscle and below the breast muscle on patients. If someone has very thin breast tissue especially over the upper pole of the breast I like to go under the muscle . If the patient has good soft tissue coverage then the patient is a candidate to go on top of the muscle. The key is good soft tissue coverage over the implant. ( btw it is Normal for plastic surgeons to have different opinions).

I like to to use breast sizers that are made specifically to try out before surgery . Mentor has a good set. The patient puts on a bra and she can place various sizes over her breast . She then looks in a mirror to see which size she likes the best.

During surgery I like to use intraopereratve breast implant sizers to confirm the size.

I use use the bloodless breast technique which I invented. Bleeding is minimal, typically there is no bruising after surgery, and recovery is a lot quicker versus traditional technique .

I hope you find this information useful. For more information please watch the enclosed video.

Joshua Halpern, MD, PA
Tampa Plastic Surgeon
4.8 out of 5 stars 63 reviews

There is no "right answer," just opinions

First of all, you are not an A cup...  I know that's what your bra says, but in my book, you are a well shaped B cup.  There are 4 things to consider with implants -- incision placement (transaxillary, periareolar, inframammary), implant placement (submuscular or subglandular), implant type (saline or silicone) and implant size.  Just based on your photos, my recommendation would be either periareolar or inframammary incision, submuscular, silicone and an implant that fits your frame.  

Ultimately, incision placement is up to you and will have little affect on your outcome.  Implant placement will have a huge impact on you down the road -- they may look good for awhile, but you will eventually need them fixed (implant visibility, increased risk of capsular contracture, bottoming out, etc).  Please reconsider going over the muscle!  As for implant type, I prefer round silicone -- they are very soft, will never deflate, and you don't need to worry about rotation of the implant.  Tear-drop implants are not new -- they get reintroduced every so often to try and convince women they are better.  They are not.  A round submuscular implant looks very natural and just like a tear-drop.  As for size, you are limited by the width of your breast.  Most "34 inch" chests will use an implant that is 12.5cm wide.  In a low profile implant, that's 250cc.  In a moderate plus profile implant (I prefer Sientra), that's 355cc.  For you , 150cc is about a cup size, so either will bump you up 1.5-2 cup sizes.  You'll be buying D or DD cup bras.  In my opinion, less is better!  I think you should go get a third opinion.  Make sure your surgeon is a member of either ASPS or ASAPS.  Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Breast Augmentation

Different types and sizes of implants have a different appearance.Also with not much tissue in your upper poles of the breast you will probably have visible rippling with an above the muscle placement.Computer imageing would be helpful for you to understand the differences.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 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.