Are High Profile Breast Implants Always a Bad Choice?

I have been reading a about high profile silicone breast implants and the long term negative affects on tissues.

I understand how this could be true if one started out as an A cup and used a 350cc implant. However, if you start out with moderate skin laxity with a B+ cup, are high profile implants going to cause the same long term damage?

I am 5’6” and 125 lbs. I currently have 375cc moderate plus silicone. I find they are too wide for my frame. I am considering the high profile and slightly smaller.

Doctor Answers 17

High Profile breast implants give excellent results

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In my practice I use high profile implant almost exclusively and find the results to be superior to moderate or moderate plus implants. I always allow the patient to choose not only the size of their implants and also the projection. I put different sized implants in a stretchy bra and let the patient choose their size. I then show them the 3 different profile implants and let them choose. I do explain that the high profile makes the breast stick out further on the chest and not as much into the axilla, arm pit area. I have found that just about all patients whether they have silicone gel or saline implants, under or over the muscle, with or without a breast lift are delighted with their high profile implants.

In Hawaii, High Profile Breast Implants Tend To Be The Best Choice

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In Hawaii, I find most of my patients having a 34", 32", or even smaller infra breast chest measurement, therefore the narrower base on high profile implants tends to be a better choice.  Also, most of my patients have minimal breast tissue and very often thin skin.  The combination of the above tends to lead to traction rippling in the moderate plus implant augmentations. 

Moderate plus implants are 84% filled with silicone whereas high profile implants are 87% filled (Allergan silicone breast implants).  With a narrower base, high profile implants with greater fill have more tension at the implant surface which gives more projection and, in my opinion, less chance of traction rippling in thin skinned, low body fat individuals, especially such as yourself since you have moderate skin laxity. 

Taking all the above into consideration, if you were my patient in Hawaii, I would recommend you use high profile implants no matter what the volume of the implant you choose. 

High profile implants

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High profile implants are usually my implant of choice because most of my patients are very narrow. If they want a  volume say in the 3-450 range, the narrower implants usually fit better on their chest.

HIgh Profile Implants Are A Good Choice For Petite Women

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If you have a narrow frame, and a chest measurement of 28" or less, the narrower high-profile implants can be a good choice. They often prevent too much of the breast from projecting laterally (out to the side.)

Are high profile implants always a bad choice?

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That is a great question.  First to let you know, my bias is that any surgery should look natural, including breast augmentation.  In Boston, my patients do not want to look "fake".  I would say that the implant that I use the most is a moderate profile plus round silicone implant.  I tell patients that we want to fill their tissues not overly stretch their tissues.  So if the breast is not "deflated" in appearance after children, then a moderate profile plus tends to look more natural.  High profiles and ultra high profiles can get a bad reputation for looking "fake" in the wrong patient. And if the breast is "tight" then the high profile may push too much on your tissues and cause some atrophy.   But if a woman has a deflated upper breast, then the higher profile can help to fill the upper breast in a natural appearing way.  Again, "fill but don't overly stretch".  The higher profile is narrower at the base for the same volume so it can also allow a little more volume in a woman with a narrower breast- but I don't like to overdo it.  So I think that high profile silicone can be a good choice for some patients. Much of this depends on your specific breast geometry and tissue characteristics.  So have a discussion with your board certified plastic surgeon.

High Profile Breast Implants

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All implants have the same effect on the breast tissues. High profile implants are no different. They are all safe. If you are referring to the stretching of the breast tissue, this has to do with the size of the implant.

Moderate profile implants usually work well for women of your size but I suspect you have a small frame and you need 300-325cc implants.

I find that the high profile implants tend to work best for shorter women with smaller breast widths. Consider a change to smaller, moderate profile implants.

Breast implant model?

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The more breast surgery I do the more I realize that there is no correlation between the size or model of implant and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saiine/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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 cup” or "fake looking" or "top heavy" 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.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

For some women, high profile breast implants are fine

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High profile implants can be a good choice depending upon the patient's desires and chest characteristics. Particularly for the women who are not looking for "natural-looking" breasts high profile implants may be fine. Give it some thought and discuss where you want to end up with your surgeon beforehand.

John P. Di Saia, MD
Orange Plastic Surgeon

High profile silicone gel implants

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Depending on your chest wall anatomy and goals, high profile silicone implants can provide an outstanding result in many women.  Please see a board certified PS to learn more about your options.

Are High Profile Breast Implants Always a Bad Choice?

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I generally prefer high profile silicone breast implants and shy away form the use fo high profile saline implants which tend to look significantly more rounder.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.