Are High Profiles Implants Mainly for Skinny Women?

High profile breast implants are not specifically designated for any particular body type. However, it is certainly more common for a thinner, taller patients to be fit into a high profile implant. Breast implants should be chosen based on two things: 1) your pre-operative breast dimensions, and 2) your desired volume increase.

    In general, high profile implants are used when moderate profile implants are going to provide a width of implant that will not fit the chest wall width or breast imprint.  High profile implants provide the same volume but at a smaller base diameter.  Kenneth Hughes, MD Los Angeles, CA

High profile implants can be used by any patient, and they are potentially suitable for augmentation, revision, or reconstruction. Breast projection is sometimes difficult to achieve in reconstruction patients, and high profile implants provide an option to improve projection. Some surgeons use them for augmentation for a similar reason (to pack in volume and/or increase projection), but I do not prefer them, and try to avoid using them for augmentation whenever possible.
For a specific implant style, as implant volume increases, so does the diameter of the implant. For a given volume implant, as the profile increases from low to medium to high, the diameter decreases proportionately. In an exaggerated sense, the low profile implant resembles a pancake, the high profile implant resembles a sphere, and the medium profile implant is in between.

As a rough general rule for breast augmentation in my practice, maximum implant diameter should approximate the width of the breast, and should not exceed it by more than several millimeters. This means that women with wider chests and breasts have more options for implant selection. In contrast, petite women with very small/narrow chests and breasts have very limited options for implant selection. With a limitation in implant selection comes a limitation in volume as well.

I prefer to use a moderate profile implant for augmentation, when I can, for a number of reasons. For a petite woman with a narrow breast width, the volume options when selecting a moderate profile implant are limited. Many of these women desire more volume than a moderate profile implant would provide. One option would be to use an implant with a diameter larger than the width of the breast, but this can lead to a number of problems; so this is a less than desirable option. Another option would be to use a high profile implant. The narrower diameter of high profile implants allows more volume to be placed in the breast. So high profile implants allow petite women the opportunity to better reach their volume goals. In my augmentation practice, this is about the only time I use high profile implants. My preference would be to avoid them, but most of these petite women desire the greater volume even after a detailed discussion of the risks and benefits.

The low surface area-to-volume ratio of high profile implants increases the biomechanical stress placed on the breast tissue. As a result, this leads to more tissue stretch, thinning of the skin, breast gland atrophy, and more deformation of the soft tissue envelope. The result is aggravated stretching of the lower pole and subsequent further settling of the implant (compared to a moderate profile implant). This may lead to unwanted descent of the inframammary crease, produce pseudoptosis with additional loss of upper pole fullness, and result in a high-riding nipple-areolar complex.

The patient ultimately has to decide what is more important, short term volume outcome with possibilities for increased morbidity, or the potential for longer term shape and tissue stability that comes with smaller volume and/or moderate profile implants.

Best wishes, Ken Dembny