How to pick a profile? (Photo)

So confused as to what size and profile to go with. My surgeon recommended a moderate plus vs. a high profile implant with 200cc since I'm already a DD and don't wish to go any bigger. My goal is to have amazing projection, no side boob, and have that nice fullness at top of breast. Does this sound like a realistic goal?

Doctor Answers 13

How to pick a profile?

Hello, 

I'm assuming your surgeon is considering a traditional vertical scar mastopexy in combination with a small implant to give you the upper pole fullness you desire. In part, I agree with him in choosing a small implant to minimize implant descent and try to keep projection long term. However, implementing a vertical mastopexy of any type will weaken the skin envelope at the scar. An analogy to this technique is similar to that of placing rubber at the center of a bridge expecting it to hold at its maximum point of tension. This is just bad engineering. Combination breast aug with breast lifts look beautiful immediately after, but they simply can't stand the test of time nor gravity. You have enough breast tissue to undergo The Horndeski Method breast lift that uses your own tissues to achieve upper pole fullness and projection without a vertical scar or breast implants. I've attached an example. This patient did not want the risks/complications and maintenance associated with breast implants nor the ugly vertical incision. I hope this helps. 

Best wishes and kind regards, 


Texas Plastic Surgeon
4.7 out of 5 stars 209 reviews

Choosing a Breast Implant Profile

The procedure that would be recommended would be a mastopexy or breast lift in combination with a breast implant or an auto-augmentation type mastopexy. Breast implant profile for a breast lift and implant (mastopexy augmentation) with a modified inverted T would be either a low profile or moderate depending on breast tissue density and goal size. A 200 high profile or moderate plus would be a poor choice of implant.

A breast lift with auto-augmentation may be a great procedure which may eliminate the need for a breast implant.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 28 reviews

Breast enhancement options

Everyone's body is shaped differently and there is no one correct answer to achieve breast enhancement.  Based on the one photograph presented you have 4 basic choices:

  1. Breast implants alone, on top of the muscle
  2. Breast lift alone (mastopexy)
  3. Breast lift combined with a small breast implant
  4. Breast lift followed by a large breast implant (2 separate procedures)

The final choice will depend on your desires, cost, scars, down time, surgeon's experience and your health status.  Based on your stated desires, I would recommend #3 above, breast lift with a small breast implant.  That will give you the upper pole fullness that you desire and a small implant will prevent the side boob.  The lift should provide the projection.

Please see a Board Certified Plastic Surgeon who specializes in breast enhancement surgery to assure yourself of the best possible result.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 73 reviews

Picking an implant profile

In my opinion the best way to pick a profile is by trying out implants in person in the office. Measurements and other objective data can be helpful but the final decision is ultimately yours. Trying out different profile implants will give you a much better feeling and confidence about the size and profile you think works best for you.

Good luck with your selection.

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Implant profile

From the photo, you need a reduction on the left side and lift on both sides to first equalize the breast volume; the implant profile is too complicated to have an in depth discussion online. Besides there is disagreement about their use based on individual surgeon philosophy. In general a moderate plus profile works well with augmentation and lift. Please look at B/A photos with your plastic surgeon. 

Matthias Solomon, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 9 reviews

How to pick a profile?

High profile implants project outwardly more and a have a narrower diameter than moderate profile implants with the same number of cc.s

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. or the type of implant. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit will help you and your surgeon choose the optimal implant. Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Robert Singer, MD FACS La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Implant Profile

Thank you for your inquiry. From your picture it appears you have asymmetry and ptosis, meaning you will likely require a lift. Regarding implant choice, I listen to what my patient wants to look like when we are finished. There is no reason why the implants can't be chosen precisely to fill the specific need. This is where the art meets up with the science. Communication with your surgeon about your goals is paramount.

William H. Gorman, MD
Austin Plastic Surgeon
3.9 out of 5 stars 18 reviews

Breast surgery

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a wise pattern breast lift. Your nipple sits below the inframammary fold and without a lift in addition to the implant, this will not have a natural shape.  A wise pattern lift with an implant can result in a very nice shape if good technique is used.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Implant profile and size

Hello, if you already have large breasts with lower nipples, small implants may not provide the amazing projection, fullness and perkiness you are seeking.  I would recommend discussing your specific goals with your surgeon.

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.