Under Muscle Gel Implants. High or Moderate Profile? 400cc or 450cc?

My only concern is size&profile. I am 36years old, breastfed 2 kids, lost volume on my breasts. Have some sagging but my nipple is still over crease. I weigh 130pounds and am very fit and toned. I am 5"4" and my breast size is a 34 Bcup. When I was breast-feeding I was a 34 Dcup. Before my kids I was a 34C cup. I want to be a D cup.

Doctor Answers 27

How to pick shape and size of breast implants.

1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating roon inventory, and put in your breasts to complete the operation

Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Implant size

I think it will take 450cc minimum to get you to a D cup. Profile depends on how wide your breast is. Once you decide on volume, you want the widest implant that will be totally covered by your natural breast. Your surgeon should be able to tell you which profile is best. 

Some patients do not understand profiles, and mistakenly believe a high profile will give more fullness superiorly. Not true. A high profile has a smaller diameter for the same volume than a moderate profile does. If you have a wide base to your breast, you may need a moderate profile. If your breast is not as wide, then moderate plus or high profile may be needed.

Again, your surgeon should help  you with this.

Good luck.

Size, profile, and implant volume

In order to increase two cup sizes, you will need a high profile implant and a silicone gel-filled implant is probably a good choice because of the lack of muscle coverage over the lateral side and underside of a breast that is borderline sagging. The implant will not lift the breast but it will look lifted because it is filled out, particularly the lower pole of the breast. However, with a relatively sagging and flat breast it will become very projected with a high profile implant and this doesn't look as natural as it looked in the past even though the volume is increased. A better choice might be a middle profile implant which would increase the breast size by 1 1/2 cups to a C/D size. 

The volume of the implant is determined by measuring the width of your breast in the upright position with arms down and subtracting 3/4 to 1 cm. This would be the diameter of the implant and would be looked up under high profile gel-filled implants (Mentor or Allergan). Whatever volume this is will fit, look good, and increase your size by about 2 cup sizes. 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Re: Under Muscle Gel Implants. High or Moderate Profile? 400cc or 450cc?

Since you have a small amount of glandular ptosis, I'd first recommend a dual plane augmentation to fill out the inferior pole and rotate the nipple areola slightly upwards. That way, you're not just filling, but lifting a little as well. 

In terms of your desire to have D cup breasts, I'd bring both sizes into the operating room and see what looks best. Based on your photo and body measurements, 450cc in a moderate plus profile seems reasonably appropriate.

I hope this helps - good luck with whatever decision you make!

Breast Implant Sizing

Hi Ms. Bolton-

Great question...and one I see quite often here on RealSelf. Unfortunately, as I have said before, sizing of breast implants are an individualized decision. A decision that can only be reached by a team of EXPERTS : You and your Board Certified Surgeon. You, because you know your body, your wants and desires (cup size, etc) and your surgeon, because he or she will get to know you, your wants and desires as well as your anatomy and they will know the implants styles and technical specifics. For a surgeon to take you out of the equation and say they will give you the result they know will make you happiest is short-sighted.

I have recently implemented new 3 Dimensional technology (that I am sure other surgeons will have a negative opinion on because it is new and they don't have it) for a couple of reasons. First, so that each individual patient has the ability to see what their post-augmentation results MAY look like (they can switch between sizes....you can see the small difference between a 400 and a 450cc implant as well as what effects different projections (High Profile, Moderate Profile Plus and Moderate Profile) will have on your final results. And Second, it has allowed me added time to more efficiently talk to patients about sizing....the 4th Dimension, time! Patients have really been excited about the exercise of seeing their results before surgery and I like spending the time with them. 

I hope this helps...my recommendation would be based on your anatomy and my measurements of your breast/chest...but I think you would be very happy with Moderate Profile PLUS 450cc implants; they will fill out the skin envelope and volumetric needs, enhance the upper and lower breast poles and may even elevate your NAC (nipple areolar complex) a touch.

I hope this helps!

Good luck....

Dr. C


John Philip Connors III, MD, FACS
Atlanta Plastic Surgeon
5.0 out of 5 stars 24 reviews

Match the implant shape to your chest

with the advent of different profiles of implants patients and their doctors can better match the implant to the patient's anatomy and desires. There are no hard and fast rules.  In general the larger the implant the greater the diameter.  The ultimate diameter should fit the patients chest wall and existing breast mound.  This decision is best made between you and your surgeon.

Randy Proffitt, MD
Mobile Plastic Surgeon
4.0 out of 5 stars 12 reviews

Under Muscle Gel Implants. High or Moderate Profile? 400cc or 450cc

Thanks for the posted photo. My choices are HP 450 cc implant. This is based upon the limited explanation and oner posted photo not an in person examination with measurements. Best of luck. 

Implant Choice Best With Thoughtful Consultation

Based on your information and photo, it sounds like your question and thoughts are very relevant and "in the right ballpark."

By way of generalization, the choice will be based upon:

  • volume: the cup size you'd like to be.
  • anatomy: what implant dimension (width) will fit your breast and chest
  • shape: the amount of fullness you want in the upper chest
    • the higher the profile, the rounder and fuller the breast shape will be

None of the experts can give you THE specifics on-line, because the best choice will be a product of a detailed discussion with your surgeon and examination.

The determination of the best implant choice should come out of that unique and individual process with a caring professional who can take your goals and anatomy into account and provide you with a thorough understanding of any relevant trade-offs.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 15 reviews

Choosing an implant

The choice of an implant requires a thorough discussion and exam to properly select the right implants for you.  Most of my patients receive either a moderate plus or high profile implant.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 19 reviews

Not possible to answer your question responsibly

Hi there-

While I would love to be able to give you the confidence you would gain from having surgeons in this community recommend an implant for you, it is VERY important to your future happiness that you understand that without a formal consultation and examination, it is simply not responsible for me to try.

The appropriate choice of an implant for any individual patient depends on not only her goals and her history (children, breast feeding, etc.), but also (and most importantly) on measurements of skin quality, quantity, and chest/breast dimensions.

My personal belief is that because this decision is so complex, and because fundamentally what you are hoping to achieve is a particular appearance (and not a particular implant), it is a mistake to commit to an implant before surgery.

Visit with a Board Certified Plastic Surgeon for a consultation- discuss your goals with them, and then trust them to guide you in the process.

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.