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In Two Consultations I've Received Differing Recommendations For Implant Profile, Why?

I have seen 2 PS's and have chose to go with one I really felt comfortable with. Both ps's measured my bwd a 14 one PS recommended me going with silicone Mod+ (we agreed on 800cc) the other PS (the one I chose) is recommending High Profile (we decided on 800cc) he said my body could handle that but I will be using saline. Is there a reason one choosing mod+ and one choosing hp? Shouldn't they have chosen the same profile going off my bwd? Or does the saline and silicone make the choice different

Doctor Answers 16

Moderate Plus vs High Profile Implant

When it comes to implant profiles, every surgeon has a different opinion on what does the best job.  However, in reality, the implant measurements tell the story.  In the moderate plus, you have an implant that does the best job of making someone look good, but also still somewhat natural.  The implant is a little wider and projects a little less.  With the HP, the diameter is narrowed and the implants project more, providing more roundness and upper pole fullness ( some women call it the " fake" or "pornstar" look).  In the 800cc, the moderate plus is pretty wide, so if your BWD is really only 14cm, then I would probably be leaning towards the 800cc HP. There is a difference between the silicone implant widths and the saline implant widths - the silicone implants are wider then their saline counterparts.  However, at 14cm, that is narrow enough to still need the HP if you are going for the 800cc.  I hope this helps.


Most people, including plastic surgeons have a different concept of beauty. In your case the only important and ideal view is your own. It is your job to convey this information and the surgeon's job to pick the implant that will best do the job. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 76 reviews

Implant profiles in saline and silicone

The ideal profile of implant to use should be based on your chest measurement and implant size chosen.  The best profile to use may actually be different in saline vs. silicone.  For example, a Mentor 800 cc HP silicone implant is 15.5 cm diameter.  Whereas an 800 cc saline moderate plus profile implant at nominal fill (800 cc) is 16.1 cm but a 700 cc moderate plus profile saline implant filled to 800 cc is around 14.9 cm diameter.

If your ideal implant diameter is around 15 cm a moderate plus profile saline or a high profile silicone would be appropriate. 

Of course, an 800 cc implant is very large and much too large for most patients.

York Jay Yates, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 102 reviews

What Implant Profile?

You should discuss your concerns with the doctor you selected and ask him/her why he/she suggested the profile over the other doctor's recommendation.  If the answer/response still leaves you wondering, then invest in another consultation with an experienced breast surgeon to help clear the smoke.

Wider implants increase the base diameter more... some doctors advocate not altering the natural breast width due to issue that may occur down the road.  I use wider implants to diminish the distance between the breast mounds and have not had the problems these other doctors worry about so much.  Just realize that with your choice of the largest  "on the shelf" size, you are accepting of the anticipated greater risks in the long run.

Curtis Wong, MD
Redding Plastic Surgeon
5.0 out of 5 stars 23 reviews

In Two Consultations I've Received Differing Recommendations For Implant Profile, Why?

All 12 expert response can help you determine what is better for you. I would return to the PS you liked and ask for a more detailed explanation so you better understand these issues. 

Different Recommendations from Different Plastic Surgeons?

Although your confusion is understandable,  it is very common for different plastic surgeons to have different recommendations for the same patient. Ultimately, you will have to do your due diligence and choose the plastic surgeon who you feel will most likely be able to achieve your goals. At that point, hopefully you will have developed a sense of trust and allow him/her to make recommendations.

Assuming both plastic surgeons are well experienced board-certified plastic surgeons you may want to ask them for the reasons behind the recommendations.

Best wishes.

Large implant equals greater rise of stretch problems with breast augmentation

When I evaluate a patient for breast augmentation I first consider the correct profile, next the base diameter and the last factor is volume.   If you have a wide chest and breast base diameter a plastic surgeon will help you pick the correct size.  Remember that time, weight and gravity are not on your side.  The larger the implant the greater the chance of a stretch deformity over the years.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

Implant profile choice for breast augmentation

Each surgeon will have a very specific opinion regarding implant profile.  If you are really a candidate for 800 cc implants you need to know that high profile (as compared to moderate+) will have more wrinkling/rippling.  Saline implants, especially in that size range, will be much firmer, have more wrinkles/ripples, and will be much more visible in terms of edge effects and contours when you are recumbent.  Silicone gel implants offer a much better and more natural result (and are warranteed for life).


Different Recommendations for Breast Implant Shape

It is not uncommon to have different recommendations but in your case, it is concerning that you are considering 800cc implants with a 14cm base width. These may be too large for you. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast Implant Profiles

Hello ItsKasey,

One can only guess why one doctor recommended MPP and the other HP, possibly the doctor who you like felt that the implant diameter of the HP more closely matched your breast diameter.  Unfortunately, both choices are poor, and will carry a higher risk of complications and early reoperation for you than is necessary.  If in fact your breast base is 14 cm, than I don't need a photo to tell you with conviction that 800 cc implants are wrong for you.  I will quote myself from a previous post here on


One can't simply pick out an implant size based solely on aesthetics, like picking out a pair of shoes. This thinking is the root cause of most complications that lead to early and unexpected reoperations, and is usually associated with inappropriate implant size or profile. There needs to be an overhaul of the whole process of breast augmentation, towards an objectively defined process that can be measured and real data obtained. It really is not about what size or shape you think you want, its about the right implant size for your anatomy.

Your choice of 800 cc implants is either 1.5 cm or 2.5 cm (almost an inch!) wider than your breast base, depending on the profile chosen, and that is not the only criteria for determining the proper implant size.  Your risk for unpredictable tissue stretch, implant dropout secondary to lowering your inframammary fold, and significant rippling are at greatest risk.

Just look for women who have had their surgery and are now posting questions on this site asking why their breasts are uneven or rippled.  There is at least one a day, and the vast majority that post photos clearly have very large implants, much larger than their anatomy would dictate.

Please reconsider your choices. 


Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 53 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.