The greatest determining factor as to how natural a breast looks after augmentation surgery is the final ratio of breast implant to breast tissue. Implant position and profile can also make a significant difference.
Implant to Breast Tissue Ratio
A large breast in which has a very small breast implant has been inserted, should look and feel very natural because it has a low implant to natural breast tissue ratio and there is a lot of breast tissue to cover up the implant. A small breast in which a very large implant is inserted will not be nearly as natural because of the large implant to breast tissue ratio. If the final result of surgery is 80% implant and 20% breast tissue.
Lack of Muscle Coverage
One of the biggest adventures of putting breast implants under the muscle is that it provides more natural tissue to cover up the implant making the breast look and feel more natural. The muscle helps to feather the transition of breast tissue off of the implant so that it is harder to tell where the edge of the implant is. Implants under the muscle have a lower risk of tippling along the edge of the implant and they have a lower risk of capsular contracture. Implants on top of the muscle tend to look more round due to a more obvious implant edge and more capsular contracture giving the breast an unnatural spherical shape, not to mention more rippling.
The profile of the implant has a lot to do with the projection of the breast and how natural the final result will look. Low profile implants, which are rarely used, have a very natural appearance but do not provide much of an improvement in breast projection. High profile implants and particularly ultra high profile implants, shaped almost like a softball, will give a lot of projection, but will look much more like round balls than natural breasts. Moderate and moderate plus profile implants tend to give a good amount of projection and look much more natural than their high profile counterparts.
Creating a Fake Result
The natural appearing breasts with implants are patients with very little breast tissue, a very large high or ultra high profile breast implant placed on top of the muscle. This is generally the worst situation as implant rippling that commonly occurs with implants on top of the muscle and the abnormal shape due to capsular contracture causes distortion of the breast implant and, therefore the breast as well.
Natural Looking Implants
Breasts with the most natural appearance after breast augmentation surgery are those who have an ideal shape to begin with and a reasonable amount to tissue to cover up a modest size implant placed under the muscle. Sticking with moderate or moderate plus profile implants provide a nice improvement in breast shape and help to provide a more natural appearance to the breasts.