21 years old/120 lbs/5'3"/no kids. Mod plus or high profile? 485cc (Photo)

Question

I had my consultation with Dr. Khorsandi last month and scheduled my surgery date for June 26th. We decided on 485 high profile cohesive silicone under the muscle. The only worry i have is would mod plus or high profile achieve the look i want. I prefer a more "natural" look. I don't care too much about upper pole fullness. Would a larger implant in mod plus be better than 485cc HP? Is there a big difference?

Urmen Desai, MD, MPH, FACS · Answer

Trust in Dr. Khorsandi (he is a good friend of mine).  He knows exactly what is he doing, which is why he is the President of the Las Vegas Society of Plastic Surgeons.  Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Keith Hodge, MD · Answer

I think that the high profile implant is more attractive for most women. It should also be a little narrower than the moderate plus implant. You don't want the implant to be wider than your natural breast. Based on your wish pictures, I would also suggest the high profile implant. Good luck!

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question!
  
After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.
  
Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.
  
Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.
  
We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.
  
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon 
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Martin Jugenburg, MD · Answer

Thank you for your question.
This question can best be answered after obtaining breast
measurements such as base width.
You must realize that profile of the implant basically
dictates how much the implant sticks out in the forward direction and by how
much the overlying breast skin is stretched.
There are low, medium, medium plus, and high profile designs
for both round and shaped implants.
When you increase the profile of the implant within an
implant of the same volume, you are essentially decreasing the diameter and
increasing its outward projection (height) giving it a more ball shape. 
Low profile implants have wider
diameter and the lowest projection
Moderate profile implants have less
projection because of their wider diameter
High profile implants are
narrower at the base and consequently have more projection
High profile implants do generally provide a fuller look in
both the upper and lower pole. This is why breasts would appear to be more
rounded and augmented rather than natural. A natural look implies a slope in
the upper pole, and a curvature in the lower pole giving the breast
distribution ratio of 45:55. Whereas, with high profile implants, you may get a
50:50 ratio. If you want to avoid top heavy look, then go for the moderate plus
profile. 
That being said, your chosen profile must be tailored to
your breast characteristics and measurements. 
If your breast width is small, then a high profile implant
will be necessary to provide a better distribution of volume within the
breasts. If you have a wider breasts, then you may require low to moderate
profiled implants to avoid the “rock in a sock” appearance.

Also note that even if you do get high profile implants,
having them placed under the muscle is more beneficial compared to over the
muscle placement as the latter comes with increased risk of breast tissue
wasting. 
Hope this helps.
Best of luck with your surgery!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Congratulations on your upcoming surgery.  You are a great candidate
for a breast augmentation.  If you desire a more natural look, then moderate profile plus would be better.  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.  This entire surgery
can be performed with a small incision technique.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Dear cpneudeck,determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

York Jay Yates, MD · Answer

Based on your starting position and goal photos I think you are on track with the high profile implant.   The goal pictures are pretty, but not naturally shaped so I wouldn't be concerned you will be "too" fake looking with a high profile.   IMO the profile is something that requires careful dimensional planning and is best determined at the time of the consultation.   You have chosen a well respected, board certified plastic surgeon for a reason, follow his advice.

Curtis Wong, MD · Answer

how the HP and Mod+ implants would sit on your chest and then you should easily be able to choose what you want for your outcome.  Wider implants (Mod+) will give a better cleavage and side boob, assuming it is not excessively wide for your chest.

Paul Wigoda, MD · Answer

The choice of which profile implant you use depends primarily on the width of your breast. The narrower you are, the higher the profile, since higher profile implants are narrower. It looks like you have a fairly narrow width based on your photos. If you were my patient, I would be more likely to use a high profile or even ultra high profile depending on your measurements. Best of luck.

21 years old/120 lbs/5'3"/no kids. Mod plus or high profile? 485cc (Photo)

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