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Implant Position: High or Centered?

I'm looking to get 300cc silicone high profile, my concern is where my nipple is going to end, I'm trying to achieve that look where your boobs have a nice slope and nipples are a bit more to the bottom (not too exaggerated) so would.centering my nipples to fue implant would give that look??

Doctor Answers (10)

Breast Implant Position

+1

In many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold.

Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).

The horizontal position of breast implants also requires a great deal of attention, both in pre-operative planning and in the operating room. Excessive lateral dissection of the implant pockets will result in augmented breasts with an excessively wide space between them in the cleavage area, and the appearance that the breasts are abnormally far apart. The result may (or may not) be tolerable in the upright standing or sitting position, but when the patient lays down in supine position (on one's back) the implants may fall far to the side and produce little to no anterior breast projection in this position. Patients with the problem almost always want it corrected, and the treatment once again is surgical: a lateral repair of the implant space, to restrain the implants from falling off to the side.

Inadequate lateral dissection, on the other hand, will result in an augmentation with an abnormal 'side by side' appearance. It is lateral projection of the breasts beyond the lateral border of the chest wall (in frontal view) that, along with the concavity of the waist profile and the convexity of the hip profile, produces the appearance of an 'hourglass figure'. While one does not want to over dissect the lateral extent of an implant pocket, careful attention must also be paid to ensure that lateral breast projection is not inadequate.

Breast implant base diameter is also of crucial importance. The base diameter (the side-to-side dimension of the implant) must be ideal for the existing horizontal dimension of the breasts preoperatively, as well as the breadth of the anterior chest in general. Obviously, a given implant volume and base diameter that works well for a small-framed patient that is 5'3" will be completely inadequate for a broad-chested patient who is 5'10". One wants to increase cleavage area fullness and lateral breast projection in most cases, and an implant of inadequate base diameter may accomplish only one of those goals, while too wide an implant will be overprojecting in both directions. Careful evaluation of all of these breast and implant dimension issues is necessary if the ultimate goal of the surgery is a natural-appearing breast augmentation.


Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 40 reviews

High implant looks younger

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The goal of breast surgery is to achieve beautiful breasts.  Beauty is determined by high position on the chest wall, roundness, symmetry, areola position and least of all volume.  You may benefit more from a lift than 300 cc high profile implants.  Without more information or photographs, it is impossible to specifically answer your question.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 125 reviews

Natural Breast Augmentation Results

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Hello. To achieve the nipple position that you desire it is best to center the implants by doing more dissection at the bottom of the breast during placement; this is easily done by a board certified plastic surgeon and will allow a natural nipple position when the implants settle. Your board certified plastic surgeon will be able to tell you in more detail what will need to be done in order to achieve the best results for your body.


Jaime Perez, MD
Breast Implant Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 26 reviews

Achieving My Goals with Breast Augmentation Surgery?

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Thank you for the question.

Achieving the look that you are trying to achieve through breast augmentation surgery will be more complicated than the use of a certain size/profile of breast implant. Without direct examination, viewing pictures and/or a few full communication through goals for size device cannot be provided.

The best advice I can give you online is:
1. Concentrate on choosing your plastic surgeon carefully.   Make sure that he/she can demonstrate significant experience helping patients in your situation. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This if communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “full C" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 720 reviews

Breast implant position and its relation to nipples

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300 cc implants would ebhance the breast size almost a cup and a half and is a good choice for average patients. Nipples are not located dead center of the breasts. Attractive breast must look natural and should have " tear drope" shape. Following a good augmentation mammoplasty nipples must end up being at least one inch above the inframammary folds ( where breasts meet chest ). An experienced local plastic surgeon should be able to give you the results you are lookinf for, the key to the operation is to preserve the inframammary fold while doing apropriate dissection to accomodate the properly choosen implants.   

Fereydoon S. Mahjouri, MD
Minneapolis Plastic Surgeon
5.0 out of 5 stars 13 reviews

Nipple positions and implants

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Your nipples may rise ever so slightly on the breast mound with implants. If you need a lift before surgery, then you will probably need a lift after surgery. Implants do not produce a breast lift.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Implant position

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The upper pole slanting also depends upon the location of implant, behind the muscle tends to cause more fullness in upper pole. In front of muscle placement gives the slant that you are referring to.

Sanjay Parashar, MD
Dubai Plastic Surgeon
5.0 out of 5 stars 6 reviews

Implant Position: High or Centered

+1

We generally try to center the implants on the nipples. At this level, by gravity most of the implant contents will be in the lower pole of the breast, similar to the appearance of a naatural breast of the enlarged size. Centering the implants at a higher position will appear to be unnatural on most breasts.

Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Breast shape and implant position

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Generally there are two ways to shape your breasts during an augmentation,positioning the implant higher will give you more upper pole fullness, choosing a higher profile implant will often do the same thing. These two variables can be used when planning someone's surgery.  In your case, a photo would be helpful, but generally a high profile implant would not give you the upper breast slope that you are describing.  It would be best for you to find photos of the breast shape you want and bring these in when you discuss your goals with your surgeon.

Leonard T. Yu, MD
Maui Plastic Surgeon
4.5 out of 5 stars 15 reviews

Your nipples don't move, but your implants will drop somewhat!

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Every experienced breast surgeon sees that implants tend to drop, soften, and settle over time, even if a tight surgical bra or elastic bandage is designed to (try to) keep implants in their "proper" position as placed in the operating room. This latter philosophy tends to cause many more re-operations for "bottomed-out" implant position, often by competitor plastic surgeons.

With that in mind, your surgeon may choose to place your implants slightly higher than their final desired position, and may also choose to help you modify or influence final implant position by use of and elastic bandeau and/or bra.

Whether or not your desired "look" is surgically and anatomically feasible (for you) is something best discussed with your plastic surgeon. Even then s/he cannot give you absolute prediction of post-op appearance, but does have the experience to help you understand the process, and how to best come as close as possible to your desired result. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 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.