Can you recommend natural looking implants?

If you have enough thickness of the soft tissue in the upper pole of your breast, then I would recommend textured silicone gel implants under the breast and in front of the muscle for the very most natural looking and feeling breasts. Unfortunately if your upper pole soft tissue is not enough to cover the ripples that are found with all breast implants, then you will need to have them placed under the muscle. In order to use the textured gel implants I would use a peri areolar incision and place the implant under the breast on the lower portion and behind the muscle in the upper portion, a dual plane.

Implant type, size, and placement all contribute to a natural appearing result with breast augmentation. The base diameter of the breast is the most important variable, and selecting an implant of moderate profile at the appropriate diameter is a good place to start. Subfascial is an option that might add a little bit of support as compared to subglandular but not as much as submuscular. Another technique called the split muscle method is sometimes a good compromise for athletic women who need more upper pole coverage but don't want the animation problems. Round implants will be softer and move in a natural way but shaped (form-stable) implants may have the best overall shape for your own anatomy.

You sound like you could be an excellent candidate for breast augmentation because of your fitness and desire for natural breast appearance. I would however suggest that there is not one ideal looking implant. The best look is probably an orchestrated interaction of your skin, muscle and breast tissue plus the implant. Your plastic surgeon should examine you and discuss his or her recommendations, and your preferences.

I suspect that the most important consideration is avoiding overly large implants. They distort your tissues and can seem disproportionate. Beyond that, implant width and dimensions should match your chest wall, breast width, and overlying tissues.

Begin with one or more consultations. Best wishes.

Breast augmentation surgery is very personal and the correct implant for you may be not the best for someone else who is the exact height and weight. To look natural you must selected a size which is correct for you breast base width. You can then select the best breast profile. I like round implants for most women but it depends on their wishes. Under the muscle looks more natural especially in the upper pole. However, when you flex your muscle the implant will move upward. For most patients this is not an issue. Good luck.

I particularly prefer cohesive gel texturized round implants in an ultra high profile, placed under the muscular fascia in average patients respecting the landmarks as the midline, the mammary fold and the anterior axillary line. We have templates available to show the patients in front of the mirror what works better in their case. Try to choose an ASAPS member plastic surgeon.

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: your individual anatomy, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS
La Jolla, California

The best cosmetic result and the best implant in any particular breast augmentation patient depends on a variety of factors, including: your individual anatomy, realistic expectations, desired outcome, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS
La Jolla, California

In my opinion the most natural looking and feeling breast come from a peri areolar (around the bottom half of the colored areola) sub mammary (under the breast on top of the muscle using a Mentor Siltex textured gel fill breast implant. The only exception to this is if the upper pole (top half) of your breast is not thick enough to hid the natural ripples in the implants and in that case I would recommend the same approach but with placing the implant under the breast tissue in the lower part of the breast and behind the muscle in the upper part of the breast, a dual plane. The size that you choose should be determined by you with the surgeon placing low profile gel implants in a stretchy bra and letting you see the different sizes you could choose.

Natural looking breast implants can absolutely be achieved. Start by viewing many, many before and after images. "Natural looking" means different things to different people. If you look at the breast implant before and after gallery on the website of a plastic surgeon, you can get an idea of their perception of "natural". Photos can also give you an opportunity to see evidence of performing surgery with expertise. A natural looking result means breast implants of the correct size, the right shape, with ideal placement of positioning. Biodimensional planning principals can help a plastic surgeon customize a plan for the ideal, natural looking breast implant surgery.