Silicone vs saline, high profile vs moderate profile: What are the pros and cons? (Photos)

Thank you for your question. A large portion of my practice is dedicated to revisionary breast surgery.  Many of my patients express an interest in a very round-appearing breast with upper pole fullness.  This is considered to the "Fake" look which can be a very beautiful and attractive appearance on the right person.  Over many years, I have developed a technique that I published 2 years ago in the International Journal of Aesthetic Surgery called "Reductive Augmentation ".  I found that in order to achieve this look, I need to use an ultra high profile silicone implant, remove a fair amount of breast tissue, and performed a breast lift.  You are a perfect candidate for this type of surgery. If you look on my website under reductive augmentation, you will see similar pictures.  Best wishes to you.

At that size a high profile will better fit your chest measurements. It will definitely give a faker look as well. The implants will provide upper pole fullness. Looks as if you have a fair amount of breast tissue, so you could possibly go above or below the muscle. Saline implants can be overfilled so that the shape of the implants maintain more fullness up top. Another option is to go with one of the more cohesive silicone implants such as a the inspira soft touch (natrelle) or mentor extra fill implants. These will also give more upper pole fullness. As you can see, there are many options. Best to consult with a board certified plastic surgeon.

Good afternoon!I perform over 200 XL augmentations a year, and give your current breasts, and the fact that you want a very round fake appearance, the best choice is saline- overfilling a saline implant will always give you a more rounded, firm, fake look when compared to any size or profile of silicone. And yes you probably need High Profile as well.

One alternative is to place high profile saline implants that can be filled to a larger volume.  However, most plastic surgeons will recommend not having 1000 cc implants due to the long term effects on the tissues.The high profile breast implant is extremely narrow at the base to provide maximum projection. High profile implants yield the fullest and most rounded results, which may look  less natural on some patients. However, high profile implants are often ideal for petite women who have a narrow chest wall.Filling type – You can get silicone gel or highly cohesive
saline gummy bear implants or saline implants. None of these are better
options than the others. However, they do have their differences when
you examine their cost, feel, and incision requirements.  The choice for
implants is really up to you.  There are pros and cons of each which
your PS can explain during your in-office consultation.  If you have a
lot of tissue to cover the implant, the advantages of silicone
for softness and less rippling are not as marked. Shape
– Silicone gel and saline implants are usually round whereas gummy bear
implants can be had in shaped or round choices depending on your
requirements. Shaped implants give a gentle sloping look to breast
profiles whereas round implants result in a fuller upper portion of your
breasts aka the upper pole. Profile – Everyone’s profile is
different and can be chosen based on input from your cosmetic surgeon.
Your doctor will arrive at this decision based on your goals as well as
existing proportions.  This factor actually has very little to do with
the result.  Almost no low profile implant is ever utilized.  Almost all
implants placed are moderate, moderate plus, or high(full) profile. 
Very few ultra high profile implants are used as they may have a higher
probability of thinning tissue over time.  The difference in diameter
and implant height among moderate, moderate plus, and high (or full)
profile implants is very little and may be less than a centimeter in
diameter for a given volume.  Size – Breast implants come in a
variety of sizes that range from 150cc all the way to 800cc and
sometimes even go larger. Most patients need a different breast implant
size for each of their breasts. This is done so that they reach the best
symmetry possible. The size chosen by patients should be based on the
size of your breasts currently, the goals you wish to achieve as well as
input from your cosmetic surgeon. Tall women with larger frames and
broader chest, shoulders, and hips can often handle larger implants that
would make smaller women's chests look overcrowded and heavier.  Placement
- I think that most plastic surgeons would agree that a breast
augmentation result where the implant is placed under the muscle (dual
plane) tends to have better longevity than a breast implant placed over
the muscle.I would recommend that you go with the size
that boosts your self-esteem, and fits your anatomy.  Choosing an
implant based on an aesthetic goal that exceeds your anatomic capacity
may lead to complications and possibly revision.

It isn’t clear what you don’t like about your current result other than you just want to be larger. Although a larger implant may give you more upper fullness they will gradually sag again and then you will need a lift.

I think it would do well with a high profile implant of that size. For my patients that are looking for that fake look that seems to be a winner… It’s narrow and has good projection but not too wide so it doesn’t make patients look heavy. Also for that round fake look up top, overfilled Saline high profile seems to do the trick.

Dear nick 2,
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

Thank you for the  question and photos and a high profile implant has a narrower base diameter then that of a moderate profile implant of the same volume so it projects out more.   Which implant that would be best for you would be determined after measurements and sizing.Dr Corbin

Large high profile gel implants would be recommended for the look you are wanting to achieve.  I agree with my colleagues that the high profile implant yields the fullest and rounded results which can offer a fake look.  Consult with a board certified plastic surgeon in your area for an in person evaluation.