Is my chest too wide for high profile implants?

Question

I had a breast augmentation 3 months ago. My doctor said I had to have low profile because of the width of my chest. I don’t like the results and my right breast is starting to bottom out already. Can I have high profile implants put in now or in the near future?

Farbod Esmailian, MD · Answer

Thanks for the photo as I can see what you are referring to.  It is difficult to give accurate advice, especially on breast revision cases as there are more factors no involved than a primary (1st time) breast surgery.I would recommend you see a board certified plastic surgeon to discuss your desires and to be accurately examined.Hope that helps.

Daniel Barrett, MD · Answer

Dear tashby82,
implant profile is a very important consideration. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This has several problematic consequences. The first is that the patient loses width and therefor cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants. High profile implants do have a role in symmastia repair (when I need to narrow the basewidth) but otherwise I try to avoid them.
Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery.  As you can imagine, it is hard to advise you without careful physical examination. Having said that, most patients are able to have higher profile breast implants utilized, assuming they are okay with overall breast implants.   Also, based on your description of concerns, adjustment of breast implant capsules (capsulorraphy)  will likely be an important part of any revisionary breast operation plan. Best wishes.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,Unfortunately photos are two dimensional and an in person evaluation is 3D. Your photos is also angling down and there is only one view. Based on what little I see there are a few things you potentially need but an in person evaluation is needed to truly offer an accurate assessment. Go back to your Board Certified Plastic Surgeon and tell him / her your concerns, I am certain they will listen and help you. What I tell all my patients is, “The bigger the implant the bigger the problems” It’s all about weight, size, and position of the implant as well as the quality of your skin and surrounding tissues.Stephen M. Davis, MD, FACS
Certified: American Board of Plastic Surgery
Member: American Society for Aesthetics Plastic Surgery 
Member: American Society of Plastic Surgeons
Member:RealSelf Hall of Fame

Is my chest too wide for high profile implants?

Answers (4)

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