Will 450 high profile silicone be able to provide the look I'm hoping for?

I'm 35 and breastfed 3 kids. I'm 5'6" 120lbs. I have a 29" rib cage with longer legs and a shorter torso. I am 32a. I want to be large 32d or small 32dd. My doctor is planning on doing under muscle implants 450cc high profile. He said the moderate wouldn't give me the upper pole fullness I want but I want the natural teardrop look and don't like the fake round look. Id like to get to a 32d or dd I just don't want torpedoes. Also will they be too narrow and not have any off the side?

Doctor Answers 15

Problems with high-profile implants.

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I like Dr. Au's answer, and agree with much of what he has to say, especially his last sentence. But I would disagree that 450cc is "too big." And I don't know without exam, but after breastfeeding 3 kids, I suspect your breast skin is not overly taut.

You want large, and that is perfectly fine, as long as your anatomy is compatible. Depending on your exact measurements, and your intra-operative pocket diameter, I would choose the lowest profile implants (widest base for a given volume) that will "fit" within your pockets and breast bases. I think 450cc may well work, but without an exam can only speculate based on my own personal experience with patients similar to you.

I read all the time (here on RealSelf and elsewhere) that my plastic surgical colleagues are recommending high profile implants "for more upper pole fullness." High profile implants have more projection for a given implant volume, but also have the narrowest base diameter for that volume. Since the "proper" inframammary crease position is a "fixed" one (anything else is too high or bottoming out), the narrowest implant will have LESS upper pole fullness. Wider (moderate plus, or even wider moderate profile) implants will have the larger diameter that gives more implant volume and fullness below the collarbones.

Sure, the HP implants give more upper pole fullness right after surgery before they have dropped, but aren't these surgeons seeing their patients more than once or twice post-op? If they do, they see that as gravity and scar maturation cause inevitable implant position dropping over 6-12 months, that upper pole fullness is lost when the narrower implants drop into final position.

To summarize, HP implants give projection, but have the narrowest base and do NOT give upper pole fullness when dropped into final position. Moderate plus or moderate profile implants are wider and will, by mathematical definition, have more fullness when their lower edge is at the same exact crease position, simply by merit of their greater diameter. Forget volume and shape for a moment. If you put a 12cm diameter ball on a table and a 14cm diameter ball on the same table, which ball "sticks up" more in the air? The HP 12cm one? NO!!!

But enough preaching from my soapbox.

I believe much of what you are asking for is perfectly compatible and reasonable. You want as big as your anatomy allows. I don't think your anatomy would allow "too big," at least by your photo and goal description. You want upper pole fullness, not too narrow, a bit of "off the side" (commonly called side-boob), but teardrop-shaped breasts that don't over project ("torpedoes"). This would be best achieved by implants of the chosen size with the widest profile your pocket dimensions would allow, with submuscular placement and appropriate release of the inferomedial muscle fibers. I would caution you that you may not get to DD, and maybe not even a full D, but that your goals are compatible with "as large as your anatomy allows, and with the lowest profile implants in the volume chosen to center beneath the nipple areola complexes.

Get additional consultations if you need them. I agree that HP implants look fake in a thin patient. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Will 450 high profile silicone be able to provide the look I'm hoping for?

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Thank you for the question and picture. Base on your photograph, you are starting at a great place and should have a very nice outcome with breast augmentation surgery.  However, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:
 1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're 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 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 "C or D cup" 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.  The use of computer imaging may be very helpful during this communication phase.

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, and the attached link, helps.

450 cc high profile breast implants may not look natural on a thin small chested woman

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Thank you for your question and photo.  You will be best served if you consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in breast surgery, and who has an excellent reputation in your community.

You need to have a breast implant sizing system consultation and look and feel moderate profile plus and high profile breast implants.  You are very small chested have a delicate thin frame and 450 cc is a very large implant size.  I understand you want a D cup but cup size varies from retailer to retailer and cannot be guaranteed with breast augmentation.  From looking at your photo only, I would not go larger than 350 cc and I do believe a moderate profile plus will give you a more natural look.

Stuffing too much into a small breast

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You have a 29 inch chest. This is small. You have small breasts with a small skin envelope and what looks to me to be a short height between the nipple and your natural fold. Your leg length and proportion of upper torso to lower body in your case makes no difference: the limiting factor is your very small chest and small breasts in which to put implants.

You want to go from an A to a full D or DD, yet you don't want a fake look, not torpedoes, yet full at the upper pole with a natural teardrop look.

That is like asking to have a car as big as a Chevy Suburban, which is easy to park in a small garage and gets 50 miles per gallon and looks and accelerates like a Corvette. You want contradictory things. You cannot at the same time be natural and full at the upper pole of the breast. You are asking to go up 3 or 4 cup sizes, when going up even 2 is a challenge in a small breast.

I think 450 cc is too large. I think the torpedoes you fear is what you'll get with this volume: in order to get that much volume in your breast, the base width would have to be small, and the height would have to be high, a high profile design. High profile is fake looking in a thin patient.

Victor Au, MD (retired)
Chapel Hill Plastic Surgeon

Will 450 high profile silicone be able to provide the look I'm hoping for?

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The High Profile implants are designed to give the fake round look you don't like. Sounds as if your doctor isn't listening. See another one that can give you what you want.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Implant Selection

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Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements.

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.

The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process.

In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size.

I wish you a safe recovery and fantastic result.

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Will 450 high profile silicone implants be able to provide the look I'm hoping for?

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It does sound like this may be a reasonable choice of implant for you however, as you can understand the ideal implants do vary considerably with your physique, height, shoulder width and chest size - also the amount of existing breast tissue you have.

It is very difficult from photographs to give you an accurate idea of which would be the ideal implant for you as we do like to do this in person with measurements.

For this reason, your plastic surgeon will be best placed to discuss the best option for you. As always, for your own peace of mind, I would recommend you get a second opinion by attending consultations with 2 or 3 other surgeons to be sure you are making the right choice for you. 

I hope this helps.

Avoid large implants

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At 5’6 and 120 lbs. you are thin and in your photograph you have a narrow abdomen. Implants as large as 450 will not fit retro-pectoral, will extrude inferiorly and laterally requiring revision. At size 32 each 100 cc’s of implant corresponds to 1 cup size change. 300 cc implants would take you up 3 cup sizes to a D and 400 cc implants would take you up 4 cup sizes to a DD. I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral since the muscle compresses it. I recommend smaller implants to avoid the torpedo look you do not desire.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

High profile

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on your slim frame I would also recommend a high profile implant if you like the 450cc range.  This will help to keep the implant out of your armpit and still give you a pretty breast shape.  Sounds like you are on the right track

450 high profile implants

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Dear HappyMomma79,

If you want a natural look then 450cc high profile implants may not be right for you.  You might want to get a second opinion from a board certified plastic surgeon in your area.  Good luck. 

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.