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“Are those real?” How do you spot augmented breasts?

I get this question all the time on a social level, from both men and women, and I certainly hear this during my breast augmentation consultations. What makes an augmented breast look natural vs “fake”? The answer to this question is multifaceted.

The first consideration is size of the implant. The more modest the implant size choice the more natural your look. It’s really that simple. If you choose a really large implant it’s not really likely that you wont look augmented. An implant size that just doesn’t fit your frame is a dead giveaway.

The second point is how much breast tissue do you have to begin with. The more of your own tissue that drapes over the implant the more natural you will look. So this becomes a problem for my more petite patients with an A cup breast. When we put the implant in there is nothing to hide the contours of the implants because there is hardly any tissue on top of it. This is the case where you see the “too round to be true” upper pole of the breast. Now I can help with that by shaping the implant pocket to allow for a more smooth transition of the muscle onto the top of the implant and you can help by choosing a smallish implant. But if you see a breast that looks like there is half a grapefruit behind it, you are looking at an augmented breast.

A large gap between the implants. This may or may not be a sign. A lot of women just have widely spaced breasts. So this can be a natural thing. It can look fake when you have a widely spaced breast and then place a large implant. When the breasts are widely spaced there tends to not be a lot of tissue along the breast bone and you get the ‘half grapefruit’ contour there is the implant is larger.

Movement. Natural breasts move more. Augmented breasts still move because the implants are not attached to you. They float around in their pockets and move with you. The problem again is when you use a larger implant. These have no room to move and tend to always point straight out even when you are laying down. When I place the implants, no matter the size, I make the pocket just the size of the implant so that they will always stay on the front of the chest. I know this doesn’t look as real but my patients love this look and they really, really hate when their implants slide to the side and leave a hallow in the middle of their breasts when they are laying down.

When you look at a breast from the side an un-augmented, mature breast will have more volume below the nipple than above. Now an augmented breast can look this way as well because over time implants assume a tear drop shape with more of the filler (gel or saline) settling to the bottom of the implant. Again, it’s all a question of size. If you choose a larger implant it will give you an unnatural fullness at the top of the breast. Size matters.

I found this question in Allure Magazine and added my own two cents to their answers.

Lee Corbett, MD

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