Will Mentor ultra high profile implants give me the natural shape I desire? (Photo)

Question

I like to achieve a DD cup from my current 34 small C cup.my PS recommended 375cc mentor implants over the muscle as I have plenty of breast tissue. He ordered ultra high profile implants which I'm worried won't give me the natural shape I'm hoping to achieve. I am terrified that i will have a big gap between my breasts and they will look stuck on. I am 5'2" and 125 lbs. I don't know what to expect, should I request high profile instead?

Thomas Fiala, MD, FACS, FRCSC · Answer

In general, ultra-high profile (UHP) implants tend to give more of that fakey look, especially when placed over the muscle.  If you are looking for a "natural" shape, they wouldn't be my first choice for most patients.  Best to address your concerns with your surgeon.  Perhaps he/she has a rationale for this selection that isn't clear from the information you've given here.

Gary Lawton, MD, FACS · Answer

HP implants, which are a more modern shape than moderate profile implants, fit most women better.  They have a more appropriate base diameter and can be made to look very natural.  High profile implants are the first choice in my opinion.  I rarely find an indication to use UHP, moderate or moderate plus implants.  The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of volume.What you need to be worried about is placing the implants on top of the muscle.  There is absolutely no reason for this approach.There are many advantages to sub muscular dual plane placement and very many disadvantages to sub glandular placement. I would see no indication to do anything but sub muscular.  This can be best accomplished with the armpit approach. The most sophisticated approach to breast augmentation is through the armpit with a surgical camera (transaxillary endoscopic). Using this modern approach the space can be crafted under direct vision, with virtually no bleeding and no postoperative bruising. Most importantly, the shape of the breast is meticulously created. The other, older methods of insertion are technologically less advanced. Both silicone and saline implants can be placed through the armpit by a surgeon with skill and experience using this approach. The incision in the crease is the oldest method of placing the implants and puts a scar directly on the breast.

Subglandular silicone implant placement is the historical approach to this surgery, and was widely used in the 1960's. The implant edges are more visible, the risk of rippling is higher, the implant is in contact with the non-sterile breast tissue so the risk of infection and capsular contracture is higher. The interface between the breast tissue and the muscle is blurred so the implant interferes with mammography more than sub muscular placement. The blood supply surrounding the implant is worse so the risk of capsular contracture is higher. The support for the implant is less so there is more long term shape abnormalities and sagging. The look of a sub glandular implant is much less appealing than a sub muscular implant. The placement of sub glandular implants makes any subsequent revision surgeries more complicated and less successful. There are no advantages to sub glandular implant placement.

Mathew A. Plant, MD, FRCSC · Answer

Without examining you it is difficult to be certain but your suspicion sounds well founded. Ultra-high profile implants will almost never give a natural appearing result but you may not be able to achieve the DD cup you want without them. If you aren't sure about what your surgeon is suggesting then I would suggest getting a second consult before proceeding with surgery. Best of luck!

Aldo Guerra, MD · Answer

There's no way to give you a recommendation based on photos online. A recommendation actually requires a physical examination and measurements of your breasts. Your plastic surgeon is attempting to make a reasonable recommendation based on your measurements while, at the same time, trying to satisfy your appetite for a big breast (DD). He/she has recommended the UHP to satisfy the breast width and your big cup. It's a compromise of sort and if you want a more natural and less projection breast implant shape you need to consider a SMALLER breast implant size. Speak with your plastic surgeon about it!!Good luck, Dr. ALDO

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

***Given your concerns, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

Generally speaking, the best the 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 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 communication will be critical in determining 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. For example, I have found that the use of words such as “natural shape” or "DD cup" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

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, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Michael Carlisle, MD - Account Suspended · Answer

Thanks for your question. I know it can be very concerning when faced with all the implant options. In my practice I feel it's important to have a surgeon who offers all types of implants (shaped and round, etc.) because each person is going for a different "look" for different reasons. If you've had the conversation about shaped versus round (I didn't see in your question) then profile is usually dependent on your current anatomy. Meaning, for your small torso (you are thin) you don't want a very wide implant. A moderate or M+ profile may give you too wide of a breast for your current breast width. If you want to "fit" 375cc into your frame, likely your implant needs to be high or ultra high profile. Only measuring your breasts will decide this. And, you can ask your surgeon how they determine which profile. But, in general, this is the way we decide. Pick the size (cc) and then adjust the profile based on the measured height, width of your current breast. Your cleavage is already fairly close (i'm guessing from your post that you like that part of you). So, the augmentation will not change that. What is "you" is going to stay you. It will just be bigger. Using too wide of an implant (lower profile) can widen the breast too much, but should not change the cleavage between your breasts. The increased size will deepen your cleavage, but not change the width of it. The best thing at this point, when feeling nervous before your surgery, is to make an appointment and talk with your surgeon.

Michael Carlisle, MD

Trained Plastic Surgeon

Michael Carlisle, MD

Trained Plastic Surgeon

Will Mentor ultra high profile implants give me the natural shape I desire? (Photo)

Answers (7)

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