Yeah, what? I also assumed that bolt-on spheres were evidence of a very bad boob job. If that shit is deliberate, I'm shocked.

Look at my comment about fake teeth, you would be surprised by how good surgeons and dental techs could do, but a bunch of patients waltz in and tell you how you should do your job. They literally demand things that look horrifying to be "extra". They treat medical procedures like it's shopping, where the customer is always right.
Now of course doctors with some spine and integrity will try to explain to them it's not the right way, but many just refuse to listen and doctor shop until they find one that does it.

Some women do that for the fake bimbo look. Not sure why but it is a fetish I guess.

Other times women choose it because its a bit cheaper than the alternative or because it allows them to go as big as they can afford (titty envy is real).

Some choose that, sometimes it's a bad job, unless you ask the individual you'll never know. and even then she'll probably deny she's had any work done.

I think it's a combination of things:

1. Type of implants. Rounder ones have fuller breasts.
2. Cost: I've always assumed the tear-drop ones cost more.
3. Surgical quality, which pairs with cost.

My estimation was always that cost was the main component, but there are definitely those whose aesthetics or - new motivation from this thread, desire to flaunt social status - leads to intentionally seeking these types of implants.

The biggest evidence of a botched job is nipple appearance and placement, and scars. Not necessarily the naturalness of the boob job, because some try to inflate their breasts in ways that no surgeon can make it look real.