Are High Profile Breast Implants Always a Bad Choice?

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. 
 

I think that you are on the right path thought wise. A high profile implant in the right person may give an outstanding result. Your job now is to communicate with your plastic surgeon what you would like to look like. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “B+” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.

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.

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.)

All silicone implants carry the same risks for rupture and capsular contracture. However, because you are looking for a narrower implant, high profile is the way to go. Check out some before and after pictures to see what size would fit you the best. As far as long term effects on the tissues, silicone implants are very well tolerated and cause miminal damage to the surrounding tissue. Being located in Baltimore, I could show you the actual implants so that you can get a true feeling for the difference between high profile and moderate plus profile implants.