Should I go moderate plus or high profile? (photos)

I recommend high profile.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Hi, thank you for your question. 
Ideal implant size is determined by a number of criteria including base width, skin stretch, thickness of the breast, surgeon's experience and most importantly, the patient's desired goal. 
You would be a great candidate for breast augmentation, but it is difficult to determine the best implant for you without examining your breasts. Some surgeons will have the patients view different breast sizes using the Vectra 3D imaging system - this will help you see what a moderate plus or high profile implant would look like. 
Make sure you consult with a board certified plastic surgeon who can show you pictures of their prior patient results. 
Best of luck!

The difference between higher and lower profiles for a given volume is projection and for a given width is volume (with the high profile implant being greater in both scenarios). The moderate plus is the most commonly used profile in my practice. It allows for the most reasonable volume in a given BWD. In my practice, low profile implants are the least commonly used (widest and flattest). I will typically reserve high profile devices for smaller framed individuals or those seeking a less subtle more dramatic change (the opposite of natural). 
In general, the difference between a high and Mod (+), in reality, is very small (on the order of millimeters).  In my practice, I generally classify profile based upon patient preference. A higher profile provides a more dramatic look (size for size) vs. a moderate (+) profile which is relatively more subtle and understated. That being said the vast majority of patients will select a moderate + profile device (especially those seeking a more natural and subtle result).
I often find it is easier to decide on a profile (rather than a volume), this combined with BWD will determine volume. Trying to match a particular volume to a profile may lead a BWD mismatch. In my practice, smaller framed individuals do prefer higher profile devices. I discourage pursuing significant volume as this is a hallmark of the "augmented" or "fake" look. Small girls typically have smaller breasts. Over-sizing leads to a frame mismatch which is not "natural." The difference between mod (+) profile and high profile is subtle and less dramatic than the difference between low profile and the alternatives. Ultimately, it is a choice between more or less subtlety.Based on your photos (self/goal), I would recommend considering higher profile devices as this will provide greater volume and projection for a given BWD.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Hi.  Although sizing is best done at your PSs office so that you can see what those sizes look like on you, I would suggest you consider high profile implants.  Based on your photos and your desires, moderate implants may be too wide and not as projecting as some of the pictures you showed.  Check in with your PS to double check what the options are and what the outcome may be if you choose one or the other.  Best of luck!

Hello and thank you for your question. You are a great candidate for a breast augmentation. It would be helpful to also know your individual breast measurements in order to determine if 540cc is the right size for you.   The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Hi deegomo,

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.

Implant profile is one of the important considerations to make. 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 is associated with several problematic consequences.

The first issue is that the patient loses width and therefore 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 base width) but otherwise I try to avoid them.

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, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

I advise my patients to not get too fixated on a size or category; often the differences are only a few millimeters and volume changes of less than 50cc are often not noticeable.  The photos you show are a good communication tool to help your surgeon know your goals.  I would discuss implant selection again with your surgeon and trust him/her to choose a size and shape that best fits your body frame and can give you the result you want.  

I would recommend full profile silicone gel implants. I use Allergan implants the full profile.   They are placed under the muscle using a keller funnel.   Either a nipple scar or inframammary scar.   The full profile gives the surgeon better cleavage.   Make sure you see a board certified plastic surgeon who specializes in breast surgery and see lots of pics.   Good luck!Andrew Cohen, MD 

Since no one on this forum knows your breast measurements ( nipple : fold distance on maximal stretch etc) no one can answer that question except your surgeon. Any advice given to you on this forum would represent only opinions, and opinions will not be useful to you in order to make this decision. It may be reasonable to consider a higher profile implant, however, the tradeoff typically is greater stretch against the soft tissue of the breast given your baseline breast footprint. Whether your breast tissue can handle that or not is based on certain breast measurements and the quality of the native skin envelope that can then be used as a platform to have a discussion with you regarding what to expect long term with respect to your final breast shape.Regards,

Dr. Ravi Somayazula

Board Certified by the American Board of Plastic Surgery- American Board of Medical Specialties

Member of the American Society of Plastic Surgeons (ASPS)- Subcommittee Task Force on Patient Safety

Member of the American Society of Aesthetic Plastic Surgeons (ASAPS)

Member of the Texas Society of Plastic Surgeons, Houston Society of Plastic Surgeons, Harris County Medical Society

Based on your wish pics, I would go with a high profile, silicone implant under the muscle, 500-600 cc range is about right.
Good Luck!