Would doing a lower profile allow for me to have less cc's, but keep upper pole fullness and implants close together?

Well, I can tell you one thing: you did not have to have two surgeries and be unhappy, with the prospect of third looming. Surgeons who use sizing systems (I like low tech: in office sizers with patient looking at herself in the mirror with her shirt on) don't expose their patients too wrong size surgery. Regardless, yo are correct, and having an expert surgeon determine the correct diameter implant will ensure upper pole fullness, not the projection of the device.

Thank you for your question. A large portion of my practice is dedicated to revision breast surgery. In your case, the best option is to place a smaller implant and perform a internal bra procedure-otherwise known as capsulorrhaphy. I wrote the very first paper on this topic over 20 years ago and perform this surgery at least 4-5 times a week. You should be able to have an excellent outcome. Best wishes to you.

Unfortunately, you have not provided photographs or told us your bra size. However, lower profile implants have a bigger base which means it can expand more medially to increase cleavage. This all depends on the pocket and how extensive it is. If the implants are in front of the muscle then the pockets can be made closer. If the implants are behind the muscle then the pockets cannot be made closer otherwise you could end up with symmastia. You might be a candidate for a simultaneous lift but more information is needed.

Best Wishes,

Gary Horndeski, M.D.

No, you really need to choose a size between those two, maybe like 450-475-525 cc's with a moderate plus profile if that fits your frame. You might still need a high profile. If you are concerned about size, go with the smaller size. Long term it will hold up better.

Generally, speaking, low profile implants create the most natural appearance. Not all patients want a natural appearance, and some women prefer extremely projected breast that look more like tennis balls on the chest. from my experience, I choose implants based on the correct diameter that fits in the breast pocket. From there on, I select higher profile implants for patients who want more volume in their augmentation. If I can get away with a lower profile implant, then I will generally lean in that direction. I increase the profile when patients have a small diameter breast and want aggressive augmentation.
Each plastic surgeon will have their own method of implant selection. That’s typically done in conjunction with input from the patient.
I personally find working with before, and after pictures to be the most helpful and useful when it comes to choosing implant size. I typically make the decision of what implant to use during surgery. Your understanding of what the patient is, hoping to achieve by reviewing a multitude of before, and after pictures which I bring to the operating room, I use temporary sizers to determine what size implant will get the correct outcome. I can then measure the implant pocket diameter. I typically have a full selection of implants available in the operating room to choose from.
Because I ultimately make the decision of what implants to choose I am in someways held accountable for my decision making. A lot of plastic surgeons would rather step out of that decision making and ask patients to select implants. That may be very convenient for plastic surgeons who can blame the patient’s implant selection on what the patient asked for.
I found that making the implant selection during surgery based on having a clear understanding of what my patient is trying to achieve and having lots of examples before, and after pictures of similar patients with similar body and breast characteristics, guiding me I can make accurate decisions that are most likely going to Deliver, consistent quality outcomes based on what the patient was, hoping to achieve.
I apologize about grammatical errors. I typically make responses using voice recognition.
Follow up with your provider or schedule a second opinion in person consultations with other plastic surgeons in your community.
I did not directly answer your question because a quality assessment requires having quality information. At a minimum that requires having complete sets of proper before and after pictures. There are simply too many variables to take in the consideration to say yes, or no.Best,
Mats Hagstrom, MD