Would it make a difference in medial cleavage to choose high profile implants vs. ultra high profile implants?

Question

Assuming this is a revision for larger implant exchange. Silicone, sub muscular placement.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. A large portion of my practice is dedicated to revisionary breast surgery.  I have to completely disagree with the opinions that I read below.  I think surgeons over think base width and chest width measurements. The higher the profile of implant and the steeper the angle of takeoff from the chest wall, the more defined the breast and better resulting cleavage. In my experience, ultra high profile implants result in the maximum cleavage.  Also, as implants get larger, there is improvement in cleavage.  The anatomy of the patient's breasts and chest wall as well as muscularity also play a role in the ultimate final outcome of cleavage.  Make sure that you see certified plastic surgeons to have extensive experience in revisionary breast surgery.  Best of luck to you.

Mark Chin, MD · Answer

Thank you for submitting your question. Cleavage, projection, upper pole fullness, and side breast are important in determining the shape of the breasts. Many measurements are taken on the breast including the base width of your breast and distance between the nipples.  Implants are generally centered under the nipple-areolar complex and wider implants create more cleavage and side breast.  I determine the maximum width of an implant that I can fit in the breast (usually under the pectoral muscle) by measuring the patient in the upright and laying position.  The nipples tend to spread apart with the patient laying on her back.  For a given volume, a narrower base implant (think 500 cc water bottle shape) will give you less cleavage and more projection while a flatter (500 cc pancake) will have less projection but more width.  Both may have the same volume yet very different shapes. For a given volume, high profile implants will be wider than ultra high profile implants but a patient can still get the same cleavage with an UHP by going larger, if the tissues permit.  Implant charts have the width and projection of all implants.  Nipples too close together limit the size of the implant and placing too wide of an implant or too big may lift the muscle attachment off the breast bone and result in what is called a "uni-boob" or symmastia/synmastia where the implants are too close together and lifts the skin; this is a difficult condition to repair.

Gerald Minniti, MD, FACS · Answer

Hello,The size and position of the implant pockets are more important than implant profile in determining the appearance of the cleavage. Go visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Anita Patel, MD, FACS · Answer

Yes, the profile of implant makes a difference in the appearance of the cleavage. Which one would be better for you requires more information to answer. I think some patients assume the higher the profile the better, but this is not true. The implant profile is just one of many factors your surgeon must consider when choosing the best implant to meet your goals. You are better off showing the surgeon photos of what you would like to achieve, and then letting the surgeon use her/his surgical judgement to determine which profile implants will get you to your goal. The higher the profile, the narrower the implant, for any given volume. In many patients the moderate plus profile implant gives the best cleavage, while the higher profile implants give the most projection. Other factors to consider are your current breast shape and volume distribution, current cleavage or lack thereof, width of the space between breasts, diameter of each breast, overall frame configuration (does your breastbone stick out farther than the rest of your chest, or lay flat with, or cave in), current breast volume, whether or not you need a lift, how dramatic of projection you desire, what your goal size is, etc. Also, for revision cases, pocket modification may also be in order, and this too would affect the cleavage appearance.

Daniel Barrett, MD · Answer

Dear The better version of Me,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 synmastia repair (when I need to narrow the basewidth) but otherwise I try to avoid them.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Would it make a difference in medial cleavage to choose high profile implants vs. ultra high profile implants?

Answers (10)

Answer: Implant profile and its effect on cleavage

Answer: Implant profile and its effect on cleavage

Answer: High profile implants

Answer: High profile implants

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Everything you need to know about Breast Implant Revision

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Would it make a difference in medial cleavage to choose high profile implants vs. ultra high profile implants?

Answers (10)

Answer: Implant profile and its effect on cleavage

Answer: Implant profile and its effect on cleavage

Answer: High profile implants

Answer: High profile implants

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.