What looks best on transgender females, high profile or moderate profile implants? (photo)

The diameter of the implant should fit your chest wall.  If the high profile is too narrow, the result could look like round balls sitting on a wide chest and in that scenario a moderate or moderate profile plus may be used.  The high profile may give more upper pole fullness, which sounds like you may prefer.  My advice is to make sure the diameter of the implant fits the chest well, then choose the look you prefer.  Try a shirt on over the implants at your preoperative visit.  This will give you a good idea of how you will look following surgery.

Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:
 1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your   desired goals  with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc  means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of  in bra sizers and computer imaging may be very helpful during this communication phase.
3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.  I find that the use of temporary  intraoperative sizers ( with the patient in the upright position)  allows for accurate selection of breast implant size/profile to achieve patient's goals as precisely as possible.
I hope this, and the attached link (dedicated to transgender patients seeking breast augmentation surgery), helps.

Thank you for the pictures.To best help you, a physical examination or picture evaluation is required from the actual patient in order to determine which procedures and in this case, implants are best for your case.Dr. Campos

so if you want to explore it further, its best for you to see results with both the textured anatomic gel implant and the smooth round implants and then decide what you think is best.  Regardless, the width has to fit on your chest and I'm not sure if you can go super large starting from male flat without using some sort of intra-operative sizer... so you want to clarify that with your surgeon as well. 

Here's how to understand implant sizing regardless of what breast size is the preoperative condition. The average female breast size is a mid B cup. An A cup is smaller than average and a C cup size is larger than average. A D cup size or larger is very large. Average size breasts would look the most natural and attract the least attention as being too big or too small. For the optimal implant that is round and smooth surface, the largest increase in size with one augmentation, unless the breast width is unusually wide or narrow for the chest diameter, is two cup sizes. If you are starting from a typical male breast then that would be a low A cup and the largest that can be obtained in one procedure with a natural looking result and avoiding distortions and problems needing revision would be a low C cup. Breast augmentation is not properly done by starting from the number of cc's of the implant and working backwards just as you wouldn't start from a dress size or a shoe size and try to retrofit it. And it is not reasonable to think that you can just pick an implant size or a desired result and expect the plastic surgeon to deliver it. The proper implants (for round, smooth surface implants below the pectoralis muscle) is one that has a diameter about 3/4 cm less than the the width of the existing external breast upright and with arms down. There are three choices for forward volume (profile) in silicone gel-filled implants -- low, medium, and high -- they are not called that but think of it in those terms. This corresponds to about one, 1 1/2, or two cup sizes of increase in apparent size of the breast. If you want to go larger than this I would recommend a properly done augmentation with implants that fit the first time and then consider a re-augmenation at a later time after the skin and tissues have accommodated the existing implant.