Breast augmentation has long been one of the most popular cosmetic surgeries in the United States, and most years it is the most requested procedure. A mainstream surgery since the 1960s, this procedure has changed a lot over the years.
In the past, breast augmentation was characterized by overly large, overly round breasts that often sat unnaturally on the chest and were harder than natural breast tissue. Since then, new techniques and implants have allowed for a more natural appearance, making it easier to increase volume without giving away your secrets.
But which is the true key to natural breast augmentation results: technique, or implants?
You Can’t Have One Without the Other
Natural breast augmentation results require a combination of technique and selecting the right implants for the patient.
Ultimately, breast augmentation techniques and more natural-looking implants work together to achieve quality results. If you combine modern techniques with an older style of implant, you’ll still get that 80s pin-up look. The same is true if you choose a teardrop implant but your surgeon uses outdated techniques.
Keep in mind that a qualified surgeon knows this, but as part of your screening process, it is a good idea to ask your potential doctors about what steps they take to achieve natural results. This will help you understand their approach and feel confident in the results they’ll deliver.
Which Techniques Might Your Doctor Use?
According to the American Board of Cosmetic Surgery, there are four primary techniques that surgeons should choose from when performing breast augmentations. These are:
- Inframammary: The incision is made in the fold beneath the breast. This allows for a wider access point for insertion. While the scar can be about two inches long, it is hidden in the crease.
- Periareolar: With this technique, the incision is made along the outer edge of the areola. This incision allows the scar to blend into the natural pigment and works well with combination augmentation and lift procedures. However, the size of the areola can limit the access point.
- Trans-Axillary: This approach makes a small incision in the armpit. Special instruments and a camera are used to aid in ensuring accurate placement, making this technique a bit trickier than the others.
- Transumbilical: Here, the incision is placed just above the navel and the implants are inserted and moved up to the breasts. It requires just one incision, while all other approaches need two.
So, out of these, which allows for the most natural results? In truth, all of them will give you natural-looking breasts if paired with the right implant. That said, current fashions and many swimsuit styles do expose the underside of the breasts, which means the inframammary approach might leave scars that give you away. However, it is also considered the best technique for placing implants under the muscle, which can offer the most natural-looking results, especially on women with minimal breast tissue.
Selecting the Correct Implants
Now that you know about the various techniques, what about the implants?
There are a few things to keep in mind if you are looking for natural results. First, keep the volume in the right range. If you are petite, you don’t want to add too much, but if you have a larger frame, you can go bigger without impacting visual balance.
Next, look for a natural shape. Round implants are no longer the default; you can opt for the more organic teardrop shape. Then, consider profile and projection: how wide the base of the implant is vs. how far it sticks out from the chest.
Ultimately, if you work with a qualified surgeon, you should be able to get the results you want. But it doesn’t hurt to head into your consultations informed and empowered.

Dr. Joseph J. Castellano is a native Floridian who grew up in the Tampa Bay area. During medical school and his 5 years of training in General Surgery, Dr. Castellano developed a strong interest in Cosmetic Surgery. He followed his residency training with an elective year of specialized training with the American Academy of Cosmetic Surgery. From 2010-2011, he completed a fellowship in Indiana focused entirely of cosmetic surgery of the face and body. During his fellowship, he received specialized training in facial rejuvenation, breast augmentation, abdominoplasty, and body contouring. Dr. Castellano received his board certification from the American College of Surgeons in 2010.
Dr. Castellano focuses on breast augmentation, abdominoplasty, liposuction, facelift, and eyelid rejuvenation. Additionally, he operates on numerous skin cancers, scar revisions, spider veins, and specializes in the management of aging skin with chemical peels and laser resurfacing.
Request a consultation to meet with Dr. Castellano and learn more about all his practice has to offer.

