Moderate plus vs. High profile for a petite frame? (Photo)

High profile implants do not provide the cleavage or width as one sees in pretty, natural breasts.  Even on thin women, it is a mistake to use this shape.  The dimensions are not even remotely close to a natural breast shape.  I cannot count how many times women with high profile implants have come to me complaining about their "funny looking" breasts.  In fact, I just switched one out last week for moderate.  Same size.  She's thrilled. You will hear doctors talk about base width and volume  as the motive for choosing this implant.  In my opinion, it's good for a text book but it isn't reality.

The pictures you have posted show me two things:1.  You will probably need more than a 200 - 250 cc implant to obtain that size unless you are naturally a B cup to begin with.2.  Most of the "wish" photos have a high profile look to them.At smaller sizes I prefer high profile implants, especially the Inspira line, as they give nice shape and projection.  Moderate + implants, at smaller sizes, often don't provide enough projection which most women want.A consultation is obviously necessary to formulate a specific surgical plan, but I hope this general information has been helpful to you!Thomas Taylor, MD, FACSPasadena, CA

I appreciate your question.

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.

Silicone will give you a 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 more liquid
silicone (less cross-linked), if this implant should rupture, it will leak only
into the scar capsule formed around the implant but may cause some discomfort
or implant distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are 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.

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

Hello,Typically, surgeons recommend high profile implants in patients like you to satisfy matching the implant width to the breast width.  Unfortunately, there is much more to biodimensional measurements then base width to determine your soft tissue capacity for implant volume, regardless of profile.If you want natural, I recommend sticking with moderate plus. High profile will look ball like, especially after a few years. Best of luck!

Thanks for your question.  Some of the pictures you provided are with implants larger than 200-250.  It somewhat depends how much breast tissue you have to start with and what type of "look" you are trying to achieve.  A more natural look will be a different type of an implant than a more "augmented" look.  Both are ok, it's just important to have these conversations with your surgeon before surgery.  Best of luck!

My recommendation is to let your surgeon use the implant that she or he feels will give you the best outcome.  I have my patients show me what they are looking for and then I use intra-operative sizers to achieve that look- sometimes a particular implant looks different than you would expect when it is put in the pocket, and so in patients like you, this approach makes sure that you simply get what you are looking for.Best of luck this summer!!!Dr. L

The perception of what is a "natural looking
breast" is very individual and varies greatly from patient to patient and
from doctor to doctor.

The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: Your individual anatomy, desired outcome, realistic expectations, a
thorough discussion with the plastic surgeon about the options, and an
understanding of the pros and cons of any particular implant choice. Proper
sizing is not just about the number of cc’s. The thickness of your tissue,
breastdimensions which include the width, height, and projection, as
well as chest wall width all need to be considered when choosing an implant.
Trying on implant “sizers” of various shapes and volumes while wearing a tight
t-shirt, bra, or bathing sit at a preoperative visit will help you and your
surgeon choose the optimal implant.
There are no manufacturers' standards for cup sizing in the bra
industry. The cups of a 32 C and a 36 C are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer. Nor is there a direct correlation between implant
shape or size and cup size.
Keep in mind that following the advice from a surgeon on this or
any other website who proposes to tell you exactly what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of each operative
procedure would not be in your best interest. I would suggest that your plastic
surgeon be certified by the American Board of Plastic Surgery and ideally a
member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.
Robert Singer, MD FACS
La Jolla, California

Hi and thanks for your question. I would try on a number of different shape and volume sizers and discuss your concerns with your plastic surgeon who is the best one to answer these questions. After 30 years performing aesthetic plastic surgery, my best advice is to seek a surgeon who is certified by the American Board of Plastic Surgery and with whom you have good communication. Good luck.

Thank you for the question. There are several steps taken to select a specific size/profile breast implant for a specific patient. The difference between the different profiles of breast implants available have to do with the dimensions (diameter and height) of the implants. For example, the high-profile implant has a greater projection and a smaller diameter compared to the moderate profile implant. The moderate plus profile implant as projection and diameter characteristics that fall between the moderate profile and high profile implants.I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.I hope this (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes.

Thanks for your post. I tend to like the higher profile implants for women who have very petite frames and narrow breast base width. You will get more projection, which most women like, and you will get added volume that way as well. The moderate profile implants can provide more cleavage, but also more volume laterally (near your underarm). The photos you show seem to be more of the high profile type to my eye. I hope that helps a little. Best wishes.