High or Low Profile Implant to Acheive Best Result? (photo)

Thank you for this challenging question.  First of all, congratulations on looking so good after breast feeding two children.  It appears that the distance form your inframammary fold to the top of your nipple is at least 7.5 cms which is my magic number.  With this number, you can put in almost any size implant without much of a problem.  There are so many questions that need to be answered.  Do you want a small D, a medium D, a large D, or a double D?  Would that D be measured at Macy's or Victoria's Secret?  You have excellent positioning of your pectoralis as it inserts into your sternum, therefore subpectoral implants of any D related size will give you plenty of cleavage, whether they are low, medium or high profile. 

I personally like the high profile implants.  I think they give a much better, tear drop like appearance.  A 340 cc, high profile, submuscular implant in my opinion would be closer to a C than a small D, but of course, I am basing that assumption on 2-dimensional pictures and not a physical exam.  I assume when you say natural, you mean soft in appearance and not phony. 

I would go with plastic surgeon A because I feel that any implants above the muscle will give you a phony look and an increased possibility of hard breasts, which will really give you a phony look. 

I agree that a D cup is not a natural cup size for your frame. That being said, I would probably use a smooth round moderate plus saline implant in the 350cc to 375cc size placed under the muscle. I prefer a one inch incision in the arm pit and use an endoscope for this procedure. Good luck and please see a board certified plastic surgeon.

The choice of implants needs to be consistent with your anatomy, objectives, lifestyle, and lifestage. My recommendation would either be moderate or moderate plus placed under the muscle. However, the recommendation needs to be confirmed with in person consultation and exam.

Each surgeon may weigh decision factors differently and have their own sense of aesthetics. Rather than focusing on the recommendation, you should focus on the surgeon. Choose an experienced and expert board certified plastic surgeon who understands your objectives and passionately wants to surpass your expectations. Once you choose the surgeon, the two of you can in collaboration choose the type, profile, and size of the implants.

It is difficult to give you a proper answer with out a proper physical exam and taking proper measurements. In general the lower profile implants have a wider base diameter and have less projection the higher profiles are narrower and more projected. The higher profile will give more fullness on top of the breast and maybe less tear drop shaped then the lower profile ones. In narrow chested women a higher profile maybe a better choice. 

 

See a few board certified experienced plastic surgeons to obtain more information.

I I commonly use high profile implants in my patients because many are very narrow and want larger implants,  It is really a personal choice.

Choosing breast implants involves first and foremost being in the right neighborhood. With the options that you have been presented with you are in the right neighborhood. Choosing the exact implant will depend on small factors that may be based on the experience or the preference of the plastic surgeon or the patient. You cannot make a wrong decision once you are in the right neighborhood. 

Have you tried on implants and then a not-too-snug top to see what look you want?

Read Dr Pousti explanation a few times. It can really help you understand. In my opinion based upon the posted photos I like HP's for you. Again we all have different opinions and experiences. 

Thank you for the question and pictures.

You are correct in that if you visit with 5 plastic surgeons you may receive 7 different pieces of advice. This is the nature of plastic surgery when there may be several different options that will achieve acceptable results.  Not to add to your confusion, but I probably would have suggested moderate or moderate plus profile implants placed in the  sub muscular (dual plane) position.

I would suggest that you do the following:
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're 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 "D” 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.

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 hope this helps.

High profile implants are more narrow than other implants.  Right now you would not get more cleavage filling up the space between your breasts and this is critical when they are as widely spaced as yours are.  I would not choose high profile implants for you.

High & low are misnomers. It is actually wider or not so wide. Any good plastic surgeon will measure your chest and breast widths to the millimeter then choose the implant width that fits your chest. Too narrow and you'll have a big flat spot between your breasts. You should try on sizers in both widths and choose the fullness you want with sizers that will give you the cleavage you want. I feel it is a big help to have pateints choose a PlayBoy photo of the breast size they want. Many times they stress that they don't want to be too big then bring rather big breast photos. A picture is worth a thousand words in this type of communication. You can have anything you want if you choose the look you want and let your surgeon choose the implant that will best producer that "look". Many times the surgeon doesn't even know exactly before the surgery how much it will take on your chest, in your empty breast skin to fill it up to the full ness you want. Don't restrict his or her doing the final fitting by choosing in advance the cc size.  Total cost is $4400.  Lawrence Foster, MD,FACS,FICS