I have wide-set breasts but a narrow frame — should I go high profile or moderate plus? (Photos)

Thank you for providing photos with your question. It is hard choosing between types of implants, so answering this question would be easier with an in-person examination. That said, plus or minus 400cc seems to be a good size for you. Because of the space between your breasts, I believe you would benefit more from a wider base and high profile implants have a smaller base then the moderate plus profile implants. If It where up to me, I would go with the moderate plus profile implants. They will help much more with your cleavage.

I would not put too much faith in the 3D images. They help give patients an idea of final results, but I can say from experience your results will be much better then that simulation, regardless of the type of implants you choose.

Please consider that your left breast is a tiny bit lower and more off to the side. Breast implants will not address this. This is MINIMAL and shouldn't be a concern...... but if it is, a small donut lift could be an option and it would help make your breasts more symmetrical.

Best of luck on your procedure!

Dr. Miguel Mota

Thank you for your question and photographs.  I think you are starting from an excellent position and should anticipate a nice result.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional ASPS board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations.  I think it wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like, but I would go with a moderate profile based on your concerns.  Best wishes!

I don't use the Vectra system because I don't think it's necessary. I talk with my patients and ask them what kind of look they want to achieve. If they want a fuller upper beast with more projection and a natural slope, then we discuss high profile implants. If they want to be more conservative with the upper breast volume and projection, then we discuss moderate or more commonly moderate plus implants. I tend to use more high profile implants on petite women because you can get a little more volume in the implant with out being too wide for the natural breast width or footprint. An experienced surgeon will put your breast implants as close together as possible. However, you need to leave the muscle attached to the breast bone, so there are limits on cleavage. However, the width between the breasts doesn't affect my recommendation regarding high profile vs moderate plus. Hope that helps and good luck!

Hi. To appropriately discuss implant size and choice, you really need an in person evaluation by a plastic surgeon with good experience with breast augmentation. Opinions and preferences will vary somewhat from one surgeon to another surgeon. Personally I start with the base width of the patient as the starting point for the footprint of the future implant. Tissue characteristics, and desired postoperative size, and patient anatomy all factor in to the proper selection of implant volume as well as profile. I go over all of that all in detail with my patients at the time of their consultation.

So in your case, based on your picture I would most likely be choosing a high profile implant. But that is just a guess since I am not measuring your frame etc. With you being thin I would typically recommend under the muscle placement. You appear to have a fair amount of space in between your breasts to start with and so you should expect to have a similar amount of space afterwards because that is largely determined by your personal anatomy and where your pectoralis muscle inserts into the sternum in the midline of the chest area. As you will see with various answers to your questions on this forum, you will get different opinions from different people and ultimately you will need to decide what makes the most sense to you. Personally, I do not like my patients picking out a profile but feel that that is my job and area of expertise to do so. My goal is to try to best meet my patient's expectations and postoperative goals, which includes size, shape and symmetry.

I would recommend consulting with a board-certified plastic surgeon with good experience in this area. He or she can thoroughly review the options with you so that you can make a good and well-informed mutual decision.

Good luck and take care,
Dr. Howell

Good afternoon!
Absolutely not- that Vectra image, besides being total BS, still has a HUGE GAP between your breasts. Go for the Mod Plus, the HP will be a mistake, and feel free to tell your PS that I said so. I perform 500-550 augmentations a year, which places me at the very top of the top of the industry in the U.S. The Vectra is a marketing tool, and a marketing tool only- no one should base a clinical decision on it. Basically if you're new into practice and/or don't have much of a breast augmentation practice, surgeons get talked into these fancy expensive imaging systems, spend a few bucks, and can impress enough patients to probably make the investment worth it. However, it is absolutely no substitute for the much superior method of actually examining the patient (wow- physical examination- what a radical idea), reviewing photos together, and then trying on sizers with several different tops. I can't tell you how many hundreds of patients have come to me from other surgeons with their 3D imaging pic in hand saying "I hate my breasts please help!"

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. You should also be aware that results of surgery can change in the future with significant weight change and/or stretching of skin from the milk of pregnancy. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame

Dear chitownchickadee,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

There is not a big difference between high profile 385cc and 415cc implants. I would say if it fits and during your sizing appointment you were happy with the 415cc implant then go for that. Once the settle they tend to look a little smaller. It's more important to make sure that they will fit, close properly and not cause a issue. If your PS is a board certified PS who is an expert in breast surgery, follow his advice based upon education, training, and years of experience.

You have a very common question asked by hundreds of patients every year. What is the difference and best implant for me? Please remember that volume or cc's is not the critical aspect of breast augmentation. It is critical that we match your body and dimensions to the appropriate implant. Most women hate the wide space in an augmentation, and that is what I see in the Vectra. It is a marketing tool and not the real world. I can create almost any image I want on the computer, but it doesn't translate to real world surgery. Measuring your base diameter, the distance between your breast and nipples and the overall shape of the breast is critical. My patients have the opportunity to try on different sizers and implant shapes and sizes with different bras and even tops you bring from home. You need to see what you would look like with your clothes after the augmentation. Trying both moderate and high profile implants, for you, would be very important to see the shape difference and projection changes to help you make the decision. Don't be locked into one shape because of a computer. You may need a second consultation with a Board Certified Plastic Surgeon to help you with the process before having surgery.

Your surgeon who has examined and measured you will be the best one to tell you which implant will give you the look you are wanting. However, if you are concerned about his/her selection, then get another opinion.