I need to decide between high profile implants and moderate plus 550 cc. Any suggestions?

Given your description, I think either one is too large.  If you already have some sagging, large implants will make that worse over time.  I don't think mod plus or high profile makes much difference, but I wouldn't go that large.

Hello,Your doctor is possibly planning on giving you exactly what you don't want with those very large implants. You may look big, fake, and not normal. Although you do not provide photos, your description seems to indicate you need a lift. Any time a surgeon says you need a very large implant to 'fill out sagging skin', then you probably need a lift. Breast implants, no matter how big or high profile DO NOT LIFT.Please visit a few surgeons who are expert in all aspects of cosmetic breast surgery, including lifts, reductions, and revisions, not just implants. ABPS certified and ASAPS members are also important criteria. Best of luck!

I suggest you clear up some issues to get the clear picture so your choice is well informed. First of all, you need to know your priority. Is it volume or a natural look? If it's volume then if the 550 CC implant can't fit into the diameter of the breast width then a high profile may be ideal. But with all that volume you may end up looking like you have a ball below your skin. If you lower the volume then you can pick a shape that's a bit more natural that fills your breast width. 

My suggestion would be to return to your surgeon and sort this (important) matter out BEFORE your procedure.An online question without sufficient information about you, no physical examination, no photos, and only a cursory understanding of your preferences (" I don't want to look too big and fake . I want lift and fullness"), diminishes the value of any specific advice offered here.

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

Hi Tina,This is a great questions however not something you should need to decide on your own. This is a very important conversation to have with your Surgeon. Based on your specific goals, situation and desired outcome your Dr. can best help you determine the solution.Wishing you all the best!Dr. Daniel BarrettBeverly Hills Plastic surgeon 

The best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look.This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus. I prefer the underarm approach so there is no scar on your breast. The new silicone is the only way to go as far a rippling as the new silicone ripples much less than saline, especially in the larger implants.

The difference between these implant styles is the width and projection of the implant. Moderate plus implants are slightly wider while high profile implants are narrower with more projection. The concept that larger implants will avoid the need for a lift is counterintuitive. Larger implants will simply increase the volume of your breasts and may increase your risk for sagging or ptosis and not correct it.

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 implant shape. 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 sit at a preoperative
visit will help you and your surgeon choose the optimal implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 DD and a 38 DD are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer. There is also no
direct correlation between an implant size or shape and resultant cup
size.
Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly 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

If fullness is a priority, a high profile implant is your best bet. Allergan had three product lines of high profile implants: Natrelle style 20 and Inspira SRF and SRX. Discuss with your surgeon the pros and cons of each. Hope this helps, good luck!