Do Ultra-high Profile Implants Cause a Shelf Look?

Your surgeon is correct, implants are placed behind the breast and should not violate normal anatomic boundaries. If your breasts are far apart preoperatively, they will be so postoperatively.

It all depends on the amount of breast tissue, your elasticity vs sagging, amount of subcutaneous fat and a number of other factors. In general however, women with smaller breasts and less fat have more of a tendency for a "Shelf Look" with higher profile implants. 

Hi,  the ultra high implants are sometimes needed because the chest width is too small to accommodate a really large implant on a small person.  If your surgeon is choosing that implant to fit on your small chest (most likely,) than he really does not have many choices unless you decide to go smaller.  If you have a large chest, than other options would probably be better.    Fortunately, placed under the muscle, it does not have to have a "shelf look."    Make sure you discuss this with your surgeon.      Best regards,  Dr. Lane Smith

Most women have a breastbone it's about four or 5 cm wide.I  tell pts with a wide breastbone that an implant with more projection may camouflage the wide sternum.If you chest is narrow you will look better with an implant whose diameter matches your chest dimensions

Hi Delta, Thank you for your question.  Overall all, what you were told makes sense to me.  A few things.  First I agree with previous comments that you should carefully consider having #1 such large implants and #2 having saline implants, especially in that size range and in ultra high projection.  In my opinion, this is going to potentially result in a lot of tissue distortion and can be very detrimental to the appearance of your breasts.  Regarding cleavage, if you press your breasts together, you will see where they fold near the center of your chest.  This is the natural space between your breasts, without the breasts pressed together this space can look wider than it actually is in some patients.  Narrowing the space between your breasts, to make it narrower than what it is naturally, puts the implant under very thin tissue, putting the implant on top of bone as your doctor described, and makes it very likely that you will the implant edge very prominently, especially with large saline implants.  It can also increase the risk of synmastia as your surgeon described.  This is not advisable.  In my office I usually work within the existing width of the breast.  Hope this helps.  Tracy M. Pfeifer, MD, MS

More likely to do so that the other profiles. Hopefully you will have a preop visit, and will as large an  implant as you are considering I would revisit the pros and cons of silicone. They will feel softer, and have fewer ripples, which can be visible in some. The implants will need to be centered on the areolas, and if widely separated, so to will be the implants. Implants will a lower profile will be wider, encroaching both on the midline, and over the chest wall laterally

All the best. 

 

Dear Delta,

Thank you for your questions.  On the first question, yes, the more projection you have on the breasts, the more 'shelf-like' they can be, especially with saline implants.  This is because saline implants tend to be more of a round water balloon, then a implant that 'hangs' normally. 

On question #2, I think there will be varied opinions on this.  I personally believe that the breasts can be altered from their normal shape to a more ideal shape, including bringing in the cleavage if the breasts are natually seperated.  This has to be done very carefully, however, because there is a risk of symastia.  Please see the below example.  In this case, the cleavage was brought in as she started out with very seperated small breasts, and the breast crease was lowered as well to create a more natural appearance.

Best Wishes,

Pablo Prichard, MD