Breast Augmentation: How to Get the Most Natural Looking Breasts

feeling-goodI have found this blog to be somewhat challenging mainly because I had to ask myself…what is meant by a natural looking breast? Is it what you remember pictured in a National Geographic magazine? Those are definitely natural. Or has Hollywood altered our perception so much that we no longer know what it is to have natural breasts. If you are considering an enhancement to your breasts, you are likely interested in additional volume and possibly improvement in shape. Let’s review some of the decisions you will need to make with your plastic surgeon, and help you understand how these decisions may affect the end appearance of your breast augmentation.

Decision #1: Should I get breast implants?

This is the first basic question to consider if you are at all concerned about a natural result. Breast implants are just not natural. Look at yourself in the mirror with a bra or swimsuit top on. Do you like your breasts overall? Is there enough volume in clothes? If you are happy with the volume in clothes, consider a breast lift as opposed to placing implants.

Small increases in volume can also be performed using fat from other areas of your body, called fat transfer or fat grafting. This avoids implants but has limitations as to how much volume increase you can expect. A breast lift with or without fat grafting is a way to improve your breasts and definitely get a natural result.

But if you feel there is not enough volume, and a small increase from fat grafting would not be enough, read on…

Decision #2: Implant choice

  • Saline or Silicone?
    Saline versus silicone for the implant fill material is really about how it feels and less about appearance. They are both breast implants therefore they both look basically the same once placed. Since silicone feels more natural, I think more patients associate them with appearing more natural, but truthfully either device is fine. The incision required for silicone implants is a little longer and the cost is slightly higher, but that is the major difference between the two devices. However, if you want a natural feel as well as appearance, silicone implants are the better choice.
  • What about profile?
    Implants come in a variety of profiles known as moderate, moderate plus or high profile. This is a way to classify the implant as to how much projection it has. Projection is how much the implant sticks out from the chest wall. The moderate profile has the least projection and the high profile the most. The more projection an implant has, the more round the result may end up. In general, a high profile implant will have a less natural appearance. If you want a more natural result, a moderate or moderate plus device would be a better choice.
  • Volume?
    It’s simple. A larger breast implant is more likely to look artificial than a smaller one. Common sense really. But there are not definitive numbers that guide you as to what a large implant is. Is 300cc large? Or do you cross the line at 500cc? This is the art of breast augmentation. And this is where your body proportions play a role. If you have a narrow frame and are short to average height, a large implant for you may be 300cc. If however you are tall with broad shoulders, your frame can easily carry a volume of 450cc. The amount of native breast tissue you have also plays a role in these decisions. The chosen projection of the implant is also considered when choosing the implant volume. When you meet with your surgeon, a breast width measurement is taken. This number guides what implants will likely fit you the best. From that range of implants, if your focus is on a natural result, choose an implant with the least volume. In general, smaller implants produce more natural results.
  • Tear drop/Shaped Implants?
    Anatomically shaped implants are a newer device on the market that allows for a more sloped appearance to the breast after enlargement. Like it sounds, the implant is not round and there is more volume in the inferior portion of the device than the superior. If you are relying on the device to give additional volume and provide an improved shape, an anatomical implant may be a good choice. The disadvantage of the device is that it can rotate and need revision surgery. I typically think of using a shaped device in someone who has lost volume after weight loss or having children, has a slight degree of droop to the breast and has a flat upper portion of the breast. In these cases, a natural and improved result can be obtained.

Decision #3: Implant location

There are two locations typically used for placement of implants for breast augmentation. They are either placed in a subglandular plane, directly under the breast tissue or in a submuscular plane, under the pectoralis major muscle. Advantages and disadvantages are associated with either location. In general, the implant placed below the muscle will give the most natural result as it is providing more soft tissue coverage.

Decision #4: Plastic Surgeon

This is key. First, you have to be honest with yourself about what you want and then you have to find the right board-certified plastic surgeon to execute your wishes. You should interview many surgeons, and find the one who you feel understands what you are trying to accomplish and what you want. Preoperatively an implant is chosen and the surgery is planned, but adjustments may have to be made in the operating room while you are asleep. You need to feel confident that your surgeon is thinking about what YOU want. I use sizers in the operating room after I create the implant pocket and then make a final decision on the implant once I see it in place. Whether you want natural or not, be sure that you trust the surgeon doing your surgery.

Breast augmentation surgery can be exciting and scary all at the same time. My advice is to meet with one of the board-certified surgeons of the Emory Aesthetic Center. We can help you understand your options, walk you through the process and get you the natural result you want.


or call us at 404-778-6880 to schedule a consultation

About Dr. Anderson

anderson-ericaErica Anderson, MD, is board certified by the American Board of Plastic Surgery and currently holds an appointment as Assistant Professor in the Division of Plastic Surgery at Emory University. Dr. Anderson completed her general surgery residency and plastic surgery residency at the University of Colorado Health Sciences Center and associated hospitals in Denver, CO. She completed a year of advanced training in Aesthetic Surgery at Grotting Plastic Surgery in Birmingham, Alabama.

Dr. Anderson returns to Emory University after being in private practice in Arlington, Virginia. While there, she maintained a busy aesthetic and reconstructive practice and also served as Medical Director for the Wound Healing and Hyperbaric Center at Virginia Hospital Center.

Dr. Anderson’s academic and research interests are largely focused on clinical outcomes with regards to cosmetic surgery. Her areas of clinical interest are diverse including cosmetic surgery of the breast and body as well chest wall reconstruction and wound care.

Dr. Anderson is married with 3 children, Trent, Connor and Fiona, and 2 vizslas, Max and Mimi.

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