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Small boobs tend to have much more graceful shapes. Also, if you ever have kids, breast-feeding is supposedly more difficult with implants.


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Here you can view actual before and after plastic surgery photographs submitted by ASPS members who have a Plastic Surgery Connect Profile in our referral service. These photographs represent typicalbut not everyone who undergoes plastic surgery will achieve the same. American Society of Plastic Surgeons. Community Home ask a surgeon patient community. Ask a Surgeon. Patient Community.

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The problem lies in understanding what a beautiful natural look is. Most think natural means low and flat and augmented means full.

Call to schedule a consultation with Dr. Rian Maercks to learn more about breast augmentation. Breast Augmentation Info. Before getting deep into this issue, I will flatly say that my thoughts about breast augmentation and breast aesthetics are VERY contraculture to the mainstream conceptions and standards of my field.

It is my opinion that many practices in medicine and plastic surgery are very dogmatic. I find the well accepted aesthetics of the augmented breast very disappointing even though this is a very high patient satisfaction procedure.

Breast augmentation: fake vs natural look

Not everyone will understand, relate to or agree with what I write here. I am unwilling to intentionally deliver unnatural appearing to the face breast or body. These three components are aberrations from mainstream plastic surgery.

Here we go… I find a great starting point for understanding mainstream breast augmentation is to use one of the tools developed by expert plastic surgeons and industry partners, a software platform called TouchMD. It is a convenient tool with patient education diagrams and videos that one can draw on in consultation.

What look is best for me?

I will use screen shots from this system to illustrate my points. Forgive the preschool looking drawings and writing displayed as this is not a high accuracy fine art system. Does the picture above look like a pair of natural breasts to you?

Lets look at why. First of all they are round like balls:. There is also a ridiculously large space between them. They are very far from midline demonstrated by the orange hashed space:. In fact it is not hard to imagine fitting a third breast between them. If you are old enough to remember Real tits that look fake movie Total Recall this will look familiar:.

So now we are left with the question: Why would a team of expert plastic surgeons and this company produce a very expensive practice enhancing software suite with such a ridiculous representation of normal untouched breast anatomy?!?! Lets take a look at why and how this has happened.

It is however important to realize that the pectoralis major muscle is not a floating pad that is likely to create a blended soft breast, it is a muscle!!! It is an important muscle that participates in most movements of daily life and arm stabilization. As such it ALWAYS has tone unless we are sleeping or dead, thus like a rope pulled taught will quickly return to the shortest distance between its origination and insertion. In the case of the pectoralis major muscle, this means the chest wall. What does this Real tits that look fake for the implant? Further downward and outward displacement as illustrated below:.

Real vs fake looking boobs

The return of the muscle towards chest wall le over time to an implant falling towards the armpit and down with a completely flat central and upper chest unless the patient is wearing a supporting and lifting garment. Now lets realize that although these features describe most augmentation out there, most women are pretty happy with them.

Mostly they look good in clothes and the breasts are bigger. Most women accept the rest. I believe this is true because they are unaware of other options. Lets again look at this in real life. The patient below did not come to me for breast concerns.

She was a model and a facial aesthetics patient of mine. When I examined her I told her that she had a good result for whats out there but in my practice I found the result to be unacceptable. The patient related that she changes in front of other models routinely and pretty much all of them look like she did. She was however interested in a revision after seeing the typical with Cold-Subfascial Breast Augmentation.

Revision from dual-plane or sub muscular is possible because the complete fascia is usually intact and window shades up with the muscle. In revision the muscle is returned to its natural anatomic position and the fascia is used to support the implant. I revised her and delivered a softer, more centralized and supported result as depicted below:.

To understand the Real tits that look fake lets look at some more illustrations. Overlying all muscles is a layer called fascia. Fascia is strong connective tissue that condenses into Real tits that look fake which allow muscles to concentrate force and pull.

It is the white stripe identified in cross section below. In Cold-Subfascial Breast AugmentationI dissect the fascia away from the muscle, as depicted by the blue line below, lifting this structure intact to be used as a shaping and supporting structure for the breast augmentation. The muscle itself stays preserved in its natural anatomic position. I dissect the fascia to create essentially a supporting and shaping support bra inside the breast.

The dissection allows control over the placement and dimensions of the implant. I select low profile anatomically shaped implants to support the cause of creating a natural shape. The width afforded by lower profile devices also allows me to create the subtle projection of the breast just lateral to chest wall to create an elegant female silhuoette.

The small amount of subcutaneous tissue depicted in yellow tends to come up with the fascia redraping and achieving a soft teardrop like effect of a natural breast. Lets compare this with what we know of subpectoral dual-plane augmentation. Below we see the flattening effect of the pectoralis major muscle on a round projecting implant. If we contrast the different approaches in profile, we will see that conventional techniques dark brown profile and practices lead to a small focused projection extra brown area that is Real tits that look fake by contrasting flatness- the augmented look.

The secondary advantages of the subfascial plane are that the implant not only is free from the displacing forces of the pectoralis major muscle, but Real tits that look fake axillary fold is also not altered. When the pectoralis major muscle is cut in dual-plane augmenation the axillary fold rises creating what I call axillary breast disjunction. This creates the appearance of a fatty collection near the armpit that bothers most women. Now I would like to demonstrate how this conception and technique lends itself to selection of implants that can never deliver natural appearing.

You probably like most viewers out there picked the one on the left to be the larger one. The fact is they are both the same exact size.

They are both mL implants. The one on the left is the style most commonly used, the type of implant all plastic surgeons are trained to use in residency myself included. They look big because all the volume is concentrated on a small narrow base. The implant on the right is an Allergan FM style implant, the line that I most commonly use which is the lowest profile anatomically shaped implant on the market. I select these because they allow me to fill out the true aesthetic dimensions of the breast.

Recall the illustration above demonstrating how the dissected muscle of the dual-plane technique limits how close the implant can get to midline. This limits the width of the implant that can be used. Similarly height is limited because the muscle will use additional height to push down further cramping the implant even lower in the inferior pole. Real tits that look fake restricted footprint of the dual-plane breast augmentation requires use of narrower shorter implants thus projection is turned to for increases in size. Unfortunately the result is a breast that is aesthetically too narrow for the chest wall and overprotection that le to more muscular force down and out.

One of the many beautiful aspects of subfascial breast augmentation is that the ideal aesthetic breast footprint can be created in most patients creating a harmonious shape that appears made by nature.

There are many reasons perhaps most importantly is that it is not taught in training. As a matter of fact in my training I was told that transaxillary breast augmentation was impossible with silicone implants, transaxillary revision was impossible and the subfascial plane does not exist.

All of these procedures are core elements of my current practice. A true subfascial augmentation particularly transaxillary through the armpit takes a more advanced skill set. Placing an implant under the muscle is very easy. When a surgeon performs a sub muscular breast augmentation, a small hole is made in the muscle, a finger is inserted into this potential space and with a quick sweeping of the finger most of the dissection is completed.

There is no potential space between the pectoral fascia and the pectorals major muscle. It is tightly bound. Thus when a true subfascial fascia preserving technique is performed such as the Cold-Subfascial technique, there is meticulous dissection required. I perform the entire procedure under direct visualization using lighted retractors and all sharp instruments like scalpel and facelift scissors. It is a different beast. It is very unlikey for a surgeon who has had years of success with a much easier procedure to adopt a more difficult one.

Another key feature to realize is that although strong, the pectoral fascia is very thin and laminar.

This means that if high power electrocautery is used in dissection much of the fascia is vaporized and if blunt dissection is used the fascia is delaminated and weakened. This is one of many reasons why I developed the Cold-Subfascial technique.

The fascia itself is well studied with many anatomic dissections and structural characterizations in the published literature. More on this to come in future blogs. I hope that I have demonstrated why the augmented look exists and why it is so well tolerated. More natural and beautiful are attainable safely and efficaciously but is very unlikely to ever be mainstream. Thanks for reading! If you have questions or suggestions for future blogs I am all ears.

Drop a note through this website or the Facebook. Until next week…. All Rights Reserved. First of all they are round like balls: There is also a ridiculously large space between them.