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

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!"