Moderate profile 350cc implants replaced with 385cc gummy high profile implant. Zero upper pole fullness?

The size difference isn't much from your old implants to the new. Most likely the old implants, as well as age and time have stretched your tissues, and therefore either a significantly larger size is needed or a more substantial powerful lift that the periareolar approach doesn't quite provide. A full lift, pocket revision, and a more substantial size increase (approx 100cc or more) can give you a fuller look.

Dear akelley111,upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. Implant profile is a very important consideration. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This has several problematic consequences. The first is that the patient loses width and therefor cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants. High profile implants do have a role in symmastia repair (when I need to narrow the basewidth) but otherwise I try to avoid them.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

(35 cc's in a gel from saline upgrade is not much at all), you will not see much benefit.  You should discuss your concerns with your surgeon and find out where the 'miscommunication' occurred and what your surgeon is responsible for and find out what options you have.  This can range from fat grafting, larger implants, or a more aggressive mastopexy.  But now one would have expected you to have much improvement with only a 35 cc difference going from saline to gel.

I am sorry to hear about your concerns after revisionary breast surgery.  It is hard to give you precise advice but it sounds like the use of larger volume implants,  adjustment of breast implant capsules (capsulorraphy) and/or revisionary breast lifting may be indicated to address your concerns and achieve your desired outcome. Best to communicate your concern/goals directly with your plastic surgeon, in front of a full length mirror and with the help of goal photographs. Best wishes.

I am sorry to hear that. It is hard to comment accurately for you without pictures. When you say gummy's do you mean shaped gummy implants or smooth round gummy implants? It makes a huge difference for upper pole volume. Sorry I can't tell you more. You need to chat with your surgeon. If you post photos let me know and I would be happy to take a look. 

Replacing 350cc Moderate profile saline implants with 385cc High profile silicone implants will provide you with less upper pole fullness because of the decrease in the base diameter of your new implants. To see a noticeable change you will need high profile implants with either the same or larger base diameter. High profile implants will give you more projection. Thank you for sharing your question. Best wishes.

If the moderate 350's had the right base diameter for your chest, the high profiles should have had the SAME DIAMETER, not less. The less diameter, the less height the implants will have and the less upper pole fullness. Typically there is 75 to 100 cc's increase from profile to profile in the same diameter. Therefore, if you went from moderate through moderate plue up to high profile, that is a 2 profile jump and should have added 150 to 200 cc to the implant volume (need to check the implant catalog), making the new ones about 500 to 550 cc's if you had kept the same diameter.