High profile (natrelle 20) or moderate plus (natrelle 15)? Height: 5'7 Weight: 135 BWD: 12-12.5 Cup Size: Small A)

I've been to two consultations. One doctor told me HP or UHP, and the other doctor told me MP. I'm confused on which would be better for me. I decided on HP because of the projection and how it sits versus MP. I'm leaning towards silicone 450 cc. My questions are: 1) What amount of cc's would get me to a D? 2) Will high profile be a good fit for my BWD? 3) Am I making a mistake going with high profile? Will getting high profile on me make my breasts look like round balls sitting on my chest?

Doctor Answers 10

Implant profile choice

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Good morning!

Implant profile is a very important parameter when deciding on an implant.  Too narrow of an implant can give you too wide of a cleavage area while too wide of an implant can give you too narrow cleavage or too much breast hanging of the side of your torso.  In my practice I find it important that I choose the profile and give the patient more leeway in regard to volume of implant- in my opinion it is important that an experienced surgeon choose the profile to be able to take into account body dimensions and tissue type.

Be sure you are with a surgeon who knows and understands the pros and cons of each profile of implant with your particular body type.  Look at lots of his/her's before and after photos to try and find a patient with a similar body type and see if you like their results.

I hope this helps.

Implant volume and cup size

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Unfortunately, you have not told us your bra size just your cup size.If you are 32 or 34 each 100 cc’s of implant corresponds to 1 cup size change.If you are 36 or 38 each 200 cc’s of implant corresponds to 1 cup size change.450 cc implants are large, will not fit retro-pectoral, will extrude inferiorly and laterally requiring revision.Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant.Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision.Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it.

Best Wishes,

Gary Horndeski, M.D.

High profile (natrelle 20) or moderate plus (natrelle 15)? Height: 5'7 Weight: 135 BWD: 12-12.5 Cup Size: Small A)

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The reason you are getting confusing recommendations is because breast augmentation is not an exact science and what surgeons recommend has a lot to do with their personal experience.  What is certain, with the information you have provided, is that with your measurements, if you really want 450 cc it has to be HP and so long as the pocket is adequately dissected and the implant is appropriately placed, and so long as you do not develop capsular contracture, you will have a nice result.  The pictures of implants looking like round balls that you see are almost always a result of capsular contracture.  In my experience complete submuscular placement reduces the chance of capsular contracture and allows for a more natural feel and appearance.

Which implant is right

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Thank you for your breast augmentation question.

The HP implant is useful for women who want more projection and who want a larger volume than will fit their chest with a moderate profile implant. 

The final result – in bra size – can be hard to predict. Depending on anatomic and bra variables a 275 cc implant can be a DD and a 430 can be a full C.

Return to the plastic surgeon with whom you had the better rapport and have a second consultation to be sure all your questions are answered.. Re-measuring you, reconsidering the implant and trying on sizers again will all help you be confident in your decision. Best wishe.s

Proflie choice

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Impllant choice is best made in the context of a complete consultation which includes the patient's aesthetic goals, the patient's anatomy and soft tissue characterisics and the patient's tolerance for revision surgery (implants too large for the soft tissue envelope put undue stress on the tissues leading to a higher need for revision).  You should re-discuss with your plastic surgeon; it is not possible to provide an informed recommendation on-line.

Michael B. Tantillo, MD
Boston Plastic Surgeon

Breast augmentation size

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This choice is made after we go over your measurements.  Personally I only rarely use HP devices because of the less natural appearance created.

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

HP definitely looks round

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Thanks for your question. Based on your measurements, your height and existing A cup, it might take a HP  implant to assure you the most volume. I would not even consider a UHP because those truly are too round in my opinion. I find the HP to be less natural and can cause more compression of the gland than the MPP. In my opinion, it is better to have a little less volume with a more natural looking breast (MPP) than to try and maximize the volume and have too round a shape (HP and UHP). Best of Luck!

Implant Size

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Thank you for your question.  Let me share with you my approach for implant sizing as this may help you to make your decision easier.  I consider two factors when selecting implants for my patients:

1. Dimensional planning
2. Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.

In my practice, patients feel more confident about their choices particularly with our unique gel implant sizing system.    I hope this is helpful.

Best wishes,

Dr. Basu
Houston, TX

High profile versus moderate profile plus breast implants

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Your concerns about a narrow projecting breast with high profile implants are real.  If you are concerned that you want fullness in the cleavage and the lateral side of the breast then perhaps moderate profile plus breast implants will be better suited for you.  I suggest another visit with your plastic surgeon to visualize the different implants and see how a high profile versus a moderate profile plus looks in your bra and try to imagine how you will look beneath your breast.  For more information on choosing breast implant size please read the following link:

Implant size.

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Although the measurements are helpful, adding photos to your posting would allow for a more reasoned response. 

I find trying on implants for my patients to result in better satisfaction with size that striving for a cup size.  Cup sizes are not uniformly defined, and I have numerous patients who, for example, have bras of B C and D cups that all fit. 

If you are looking at the 450 cc range, a moderate plus would be too wide for your frame. A moderate profile would be way too wide.  As a general rule, the moderate plus implants are somewhat more likely to look natural compared with high profile implants.  I find XHP implants to look rather unnatural except in larger patients. 

Although by BWD the high profile 450 would be acceptable, that is only one of several criteria your surgeon will be using to pick a size. 

Thanks for your question. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.