Disclaimer:
The purpose of this page is NOT to publicly shame. Rather, if you are considering breast surgery for the first time, this may help define your objectives.
If you think you may have an unsatisfactory result from previous surgery, you are not alone. I may be able to help you.
As you peruse these photos, understand rarely will I reveal my personal tastes in breast shape and cup size. What I will tell you is whether your goals are achievable and safe. I will tell you if I believe you already have a beautiful result or have a deformity which could be improved. I will tell you if there is a problem and what can possibly be done to fix it. I will rarely say you should select a different size of implant... unless safety is a concern. That you will decide following a lengthy consultation, typically by trying on many different implants in the privacy of our office. As with any elective cosmetic surgery, realistic expectations are paramount for this to be a rewarding experience.
I am selective on whom I operate and will not hesitate to refer you elsewhere if that is in your best interest. I only agree to operate, when I am convinced I can deliver the best results. If you're not happy, I am not happy.
Every patient I operate, regardless of station in life, is treated with complete respect and anonymity.
I am not revealing whether any of these Red Carpet women have sought my professional services; or what, if any, plastic surgery they may have had. All of these images are in the public domain.
- John Baeke, M.D.
RC 52
One of the most iconic Hollywood moments ever captured on film (1957). There is no denying, whether a gift from God or your plastic surgeon, large breasts give some women confidence... and intimidation. As this photo of Sophia Loren (left) and Jayne Mansfield pre-dated the first silicone breast implant surgery by 5 years, one must assume plastic surgery was not the talk of the table.
RC 1
"Side boobs". This well-known model shows precisely the side-boob look many desire. Note the side of her breasts extends beyond her chest wall. Many women tell me they find this a sensual look and feel. To create this, a woman will need a wider diameter implant. Such an implant should also give tighter cleavage and more upper breast fullness.
RC 2
Profile. What profile of breast do you want? A naked breast typically has a "teardrop" shape, with a slight concavity from the upper chest to the nipple. In a push-up bra, this becomes much fuller giving the upper breast a convexity or "S" shape. Some women want their naked breasts to have a more natural profile; others want the fuller (unnatural?) upper pole as in this photo.
RC 4
No doubt big implants can give luscious breasts with great cleavage and a curvaceous figure, but as you can see from this photo, as larger implants are heavier, it is difficult to maintain fullness of the upper breast... especially if the woman chooses to rarely wear a support bra.
RC 5
One common mistake many plastic surgeons make when placing large breast implants is lowering the attachment of the breast to the chest wall. Indeed, this will create a larger pocket to place the implant, but over time the heavier implant can continue to drop lower and lower causing loss of upper breast fullness, too much fullness of the lower breast and often malposition of the nipple.
RC 6
Side Boob. Again, to get the full side boob, typically requires a larger/wider (i.e. heavier) implant, which over time may cause the breast skin to stretch and fall. Fair skinned women (e.g. North Atlantic descent) are more at risk for this as their skin is thinner. The model in the photo must know this as she is wearing some support.
RC 7 & 24
"Symmastia" is a complication I hope none of my patients ever experience, as it is quite difficult to correct. (In my opinion) beautiful cleavage is when both breasts touch or "kiss" at the body of the breast, but not at the base, directly atop the breastbone. Only millimeters of over dissection by the surgeon can separate beautifully tight cleavage from unsightly symmastia. The women in these 2 photos seems to have a slight degree of symmastia, which I would not advise correcting. In markedly severe cases, there can actually be a communication between the breasts where the right and left implants actually touch under the skin. In such a case, there is no cleavage, and surgery is the only option to correct. Some wags call this the "unna boob". Again, the women in these photos have the mildest degree of symmastia.
RC 8
Ptosis. The medical term for a fallen breast is "ptosis", pronounced toe•sis. In this photo, the patient's right breast is mildly ptotic; while the opposite breast has an adhesive bandage under her t-shirt lifting her breast. Many believe a small amount of ptosis gives a natural look. More severe degrees of ptosis ("ball in a sock") require a surgical procedure called a breast lift or mastopexy.
RC 9
Complications. My heart breaks for this starlet, but fortunately she does not seem too bothered by what seems to be a poor surgical outcome. This dramatic asymmetry (i.e. right ≠ left) was likely caused by the implant pocket (on patient's left) extending below the lower attachment of the breast to the chest wall (infra mammary fold). Some surgeons will cut through this critical structure as a method of correcting ptosis ("droopy" breast), but that is usually il-advised. Whatever the issue, this problem can be corrected.
RC 11
Pseudo-ptosis. This woman has the classic case of "pseudo-ptosis" or "glandular ptosis". With plain ptosis, both the nipple & breast have fallen, with the nipple often pointing toward the ground. In pseudo-ptosis, the nipples are actually in the proper position relative to the chest; only the lower breast mound has fallen beneath the nipple, as you see here. In other words, there is too much breast below the nipple. Unfortunately, even the bustier-top this celeb is wearing is unable to correct this problem. Though rather uncommon, pseudo-ptosis is nearly always seen in women who have had prior breast surgery. Fortunately, the surgical fix is relatively straightforward.
RC 12
Unnatural Result. This woman has a couple unfortunate problems. First, the photo would suggest all the telltale signs of below average breast surgery. As she is braless, a natural breast should have a more concave upper profile and rounded lower shape (i.e. teardrop). As shown by the curved red lines, her upper breast is convex and lower breast is concave. Neither is proper. This most likely reflects the implant being placed beneath the pectoralis muscle and/or distortion from capsule contracture. The breasts just look firm and unnatural. The reader is referred to another page on my website where I discuss both these situations in more detail. Also, note the arrow pointing to the unsightly surgical scar beneath the breast... not good. This lady deserved better.
RC 13
Fabulous result. This is the reason many women want larger implants. Great curves and tight cleavage where the breasts "kiss". Obviously, she does not have a hint of capsule contracture.
RC 14, 15 & 45
Thin Women. There are many unique considerations in performing breast augmentation in thin women. With precious little natural breast tissue and fat, any wrinkle in the implant will show through the skin. I will say to new patients (in jest) you can almost read the implant serial number through your skin. All of the women shown have extraordinarily thin pectoralis muscles, thus placing the implants behind the muscle will not provide much additional padding; and still carries the additional problems of retro-pectoral implant placement (implant movement, lack of natural shape, etc.). Rule of thumb: As the size of implant goes up, so does the risk of complications, this is especially true in thin women. Thus, in thin women, "less can be more". In my opinion, all of these women would get beautiful results, even if only selecting a 1 cup size implant.
RC 16
And here is just such and example. This photo shows that a woman who is just as thin as the previous three, can completely change her entire feminine profile with (presumably) just a breast augmentation. Yes, when performed correctly, even small implants can give beautiful side boobs
RC 17, 34 & 35
"Boxy" Cleavage. To many, this look is not unappealing, but is typical of the result of placing implants behind the pectoralis muscle (retro-pectoral). I will gladly place implants behind the muscle if that is the informed decision of my patient, but it is easier to get tight cleavage when implants are placed in front of the muscle. The first example has decent cleavage. The next 2 (in my opinion)... not so good.
RC 18
Again, women don't have to have large breasts to have a sexy curvaceous figure.
RC 19 & 42
Large Implants are fun and can get you side boobs and cleavage like these 2 models, but will dramatically limit your choice of fashions. I should know, my wife has large implants.
RC 20
The Falling Breast. If you study the profile shape of this breast, you can imagine how the weight of her breast is pulling down on the upper portion of her breast skin causing the breast to slowly develop ptosis or pseudo-ptosis over time (described elsewhere). Though this does not happen in all women, those considering large implants should take this into consideration.
RC 21 & 43
In Front or Behind? You try being the expert. Which model likely has implants in front of the muscle, and which is behind?
RC 25 & 36
Large Nipples. Some women, even those not lactating, can have nipples which are much larger than average. Yes, there is a relatively simple correction for reducing nipple prominence. You can also find many examples of women who have areolae (the dark ring around the nipples) which are quite large and unattractive (much larger than this example photo). Both of these situations can limit a woman's choices in fashion. Fortunately, both conditions can be corrected by a skilled plastic surgeon.
RC 26
Implant Wrinkles. Women with implants larger than the pocket created by the surgeon; or with saline implants, will often have visible implant wrinkles. This photo suggests that might be the problem with this lady. Beautiful breasts should have a gentle curve at the top, not an angle.
RC 27
Capsule Contracture. More on this vexing problem. Natural breasts are rarely this perky. This lady likely has firm scar capsule formation around her implants. There are several treatment options for capsular contracture. Some women choose to ignore the matter, which is fine. There is no health consequence to capsule contracture. Some may wish to try an off-label use of a commonly used oral asthma medication zafirlukast (Accolate®; AstraZeneca Pharmaceuticals, Wilmington, DE). Others may opt for an in-office procedure called a "closed capsulotomy", which is often an effective procedure but no longer endorsed by the American Board of Plastic Surgeons; or finally surgical revision to release or remove the scar tissue.
RC 28
Dolly Parton. Nobody has had more fun having breast implants than lovable Dolly. Everything from songs to bridges pay tribute to her buxom figure. At age 75, she still knows how to strike a pose. Said Dolly, "If I see something sagging, bagging or dragging, I'll get it nipped, tucked or sucked."
RC 29
Macromastia. Not sure if this young girl is proud or unhappy. Yes, I perform breast reductions as well. Some women might be envious, but to most this is way too much of a good thing. Besides the nightmare of finding proper fitting clothing, breasts of this size cause back pain, shoulder grooving and a constant sweating, infected rash beneath the breasts. Insurance typically pays to have such breasts reduced.
RC 30
The "inframammary" incision (as shown in this candid photo) does not heal as inconspicuously as will the peri-areolar scar. Women with so little body fat and natural breast tissue should seriously consider the more natural shape and fewer wrinkles of gel implants. Note the wrinkles showing through the skin of the lower breast.
RC 32
Areolae. The darker circle of skin around the nipple is the areola. Without a doubt, the easiest to hide surgical scar is when the incision is placed precisely around the outer edge of the areola, called the "peri-areolar" approach. To place implants in this manner, is difficult in women who have small areolae or in women desiring larger gel implants. As saline implants are inserted deflated, they can usually be inserted via this approach. Average areola diameter is 42mm. I have also placed many silicone gel implants via this ("peri-areolar") approach but this can only be decided after consultation. The alternative incision location is beneath the breast ("inframammary" approach). I strongly advise women to never choose to have your implants placed through incisions placed in the arm pit or belly button.
RC 37 & 38
Breast Asymmetry. The most common cause for late term breast asymmetry (i.e. right ≠ left) is the development of a capsule contracture ("CC"). Over time, all breast implants will develop an enveloping shell of scar tissue; that is to be expected. Fortunately, in most women, this scar tissue remains paper-thin, soft & supple; they are completely unaware of it. However, in a small percentage of women, this scar tissue can slowly thicken, distorting the shape and feel of the naked breast. As you can see from these 2 examples of women who presumably have this problem, their left breasts have much more upper fullness than the right. Likely the left breasts are also firmer. This situation can develop in a single breast or both. There has been some success in softening the breast tissue with non-surgical means; but in most women, revisive surgery is recommended.
RC 39 & 40
Breast Shape. The top half of the breasts are commonly referred to as the "upper pole". Some women want the look shown with the Left Photo, where there is much fullness (a convexity). These breasts look like the woman is wearing a push-up bra, when she is obviously braless. It is apparent this woman has implants, and that is exactly the look some women seek. These women have told me, "If I am going to pay big money for this surgery, I darn well don't want anyone wondering if I had surgery." Other women prefer the more natural look as shown in the Right Photo. Note the upper pole of the breast has a more natural concave contour. These women will confide in me, "I want people to wonder, 'Did she?'"
RC 41
What I call "Goldie Locks Boobs" Not too big. Not too small. Juuust right.
RC 44
This image I saved from the Fashion pages of The Kansas City Star. This supermodel obviously struggles with an embarrassing problem common to many women. Regardless of how large or small a woman’s breasts, the tail of the breast (that portion nearest the underarm) can be over-developed and bulge out when wearing certain sleeveless or halter fashions. For women suffering with this bit of anatomy, it can limit your choice in attire. Fortunately, this is a situation easily remedied by surgery.
RC 46
Why??? I can give you beautiful breasts. What you choose to do with them after that is up to you.
RC 47, 50 & 51
Three more fabulous results. These women have all the boxes checked. Cleavage that is not boxy, but "kisses". No visible wrinkles, good symmetry, no apparent capsule contracture, fabulous upper pole fullness and a little side boob which can only accentuate a slim waist.
RC 48 & 49
Women can lose significant breast glandular and fatty tissue (typically following pregnancy, weight loss or aging) but the breast skin may not shrink around the smaller breast. Often this leaves the woman with saggy breasts. I use the analogy of a woman with B cup breasts only wearing a D cup bra (the skin). In my opinion this woman does not necessarily need larger cup-size breasts, only perkier. Women who are happy with their natural cup size when wearing a bra, but just don't like the droopy shape when braless should consider a simple breast lift (mastopexy).
RC 53
Again... Why oh why? In what appears a fresh scar on her breasts, this lady's choice of evening attire is a bit curious.
RC 59
Ladies. If you are embarrassed with inverted nipples, don't do this. There is a better way to cure the problem. The good news is, I can provide you a simple surgical fix.
RC 60
Placing implants in a body-builder is risky, for several reasons. For starters, their pectoral muscle is typically quite thick, and the overlying skin quite thin. Such women deserve very careful planning and realistic expectations to get a good result. Their competitive career is on the line.
RC 61
At least she is smiling. This lady obviously has breast implants. Her right breast may or may not have a postoperative hematoma (bleeding around the implant) but this is how that would look. More likely, she has a severe capsular contracture (abnormal formation of scar tissue around the implant). Either way, if the goal was to give her natural appearing breasts, that did not happen. The good news is, a problem like this has a very high chance of success, with the proper corrective operation. Hopefully, today she is happy with 2 symmetrical breasts.
RC 62
This is the classic look of saline implant wrinkles. Assuming indeed that is what she has, she is a walking advertisement for silicone implants. Her best and simplest fix would simply be to switch saline for silicone implants (with some pocket work too).
RC 63
It matters not how much effort the plastic surgeon puts toward creating 2 beautiful breast mounds, if he doesn't devote just as much attention to beautiful cleavage, nobody will ever admire her breasts. A woman's cleavage demands perfection. In a room full of evening gowns, rest assured the lens of the paparazzi will look past all the beautiful breasts and focus on the unfortunate woman with lesser cleavage.
RC 64 & 65
A woman considering lip enhancement either by injection with fillers or permanent implants needs to decide a) how much enhancement she is desiring, subtle or obvious b) whether she wants the upper or lower lip to be fuller or more "pouty"; or both lips about equal, and c) if she wants the central part of the mid upper lip (the "cupid's bow") to be preserved, or level that out.
RC 66
Apparently, this young woman is content with her figure and certainly not lacking for self-confidence. Breast implants are not for everyone.
RC 58
Neither God nor plastic surgeon has ever given any woman 2 breasts which are perfectly symmetrical. Even artists (such as this example) depict women with their naturally asymmetrical breasts.
RC 68
Plastic surgeons need to be conscious of today's fashion trends highlighting side-boob.
RC 69
Women with so little body fat desiring implants should proceed very carefully. Beautiful breasts can be theirs, but these women need a plastic surgeon aware of the unique challenges such women present.
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