LUCK PURE ULTIMATE LUCK!
Age: sure its a factor but i started at 16 i dont have natural looking ones.
Genetic: this is not 100% true but hey surely plays some part in it.
Plastic Surgery: if you didnt develop enough you wont come out looking natural either, then remember the 10 year renewal plan on those.
I did however what a few documentries on cases where trans women took high doses of proestrogen and estrogen to allow breast feeding, and after it all they sure had more natural looking breasts.
So to be honest this whole breast thing is luck in my eyes.