Moderate or high profile for small frame?

Question

I am 4'11" and weigh about 95 pounds. I am choosing 300cc silicone implants. I am afraid that size is still too big for me. My surgeon wants me to do high profile implants. I always thought high profile implants look unnatural and i prefer a more natural look and dont want my breasts to look so large but he says that moderate profile looks too wide on small frames. Is this true? Would i still look natural with 300cc high profile silicone implants placed behind the muscle?

Ronald J. Edelson, MD · Answer

The profile of the implants is a matter of personal preference.  I think 300 cc implants are a reasonable size given your build.  I usually use either moderate plus of high profile implants and think they are quite similar.

Steven Teitelbaum, MD · Answer

The argument for high profile implants is that  it is a way of forcing in more volume in a patient with limited breast width..  But doing so has the following undesirable consequences:-you will look spherical and fake (just be sure you want that).  Breasts are not spheres.-the excessive pressure of the implant will compress your breast tissue, stretch your skin, and create a bowl-shaped deformity of your rib cage-at 4"11 and 90 pounds a 300cc high profile implant will never look good decades into the future.  It will leave your tissues irrevocably damaged and put you at risk for uncorrectable deformities down the line.  The toughest breast revision problems involved thinned and stretched tissue.If sized for proper base width, high profile implants have too much volume for the breast.  If sized for volume, they are too narrow for a breast.  Their use in augmentation should be severely limited.  Doing a large number of revisions, i have developed a great degree of trepidation for their use in primary augmentation, and I am concerned about their relatively widespread use.  Short term fake results may be the result, but long term these implants are all too frequently destructive to tissue.  To be clear, I'm not saying that they are always bad for everyone.  I am saying that they damage tissue too often to be used very often.Here's the bottom line: if gaining a certain size is worth looking fake and having breasts that will not look good for much of your life, then go ahead.  Otherwise, be wise and choose a different sized and shaped implant.See pictures below of what happens when tissue thins from large implants.

Keith Hodge, MD · Answer

I like high profile implants on petite women because you can get more volume in without the implant being too wide. High profile implants do give more upper breast volume, but they don't have to look fake. There are multiple sizes less than 300cc's. I encourage you to look at these before making a final decision. Good luck!

Luis Macias, MD, FACS · Answer

High profile implants are used by some surgeons for narrow breast width patients if they want a size larger than a moderate profile implant will accommodate.  Also, not all implants manufacturers make their profiles the same, despite using the same wording for their different profiles adding the the confusion.  Therefore many surgeons, including myself, look at your measurements, the breast implant measurements and try and find one that best meets your desired final look. If you are unsure, seek a second opinion with an in person consultation with a board-certified plastic surgeon (by the American Board of Plastic Surgery). I hope this helps and best wishes.

Vincent N. Zubowicz, MD · Answer

Once patient has decided the ultimate size of the desired breast it is responsibility of the surgeon to match the profile to the anatomic measurements of the chest wall.

M. Ryan Khosravi, MD, FACS · Answer

I'm answering your question without examing you!!! However if the width of the implant be 1 cm or more less than your breast width and if there is no other situations could be existing besides eg. Ptosis or tubular breast, I can say 80-85 % fill of high profile could be reasonable. At the end I'll stress that everything is going back to the examination and should be clear between you and your plastic surgeon prior surgery. Good Luck

W. Bryant Walker, MD · Answer

It sounds like you are well into your breast augmentation journey and have found your surgeon.  If you have not shared a "wish pic" with your surgeon, I would recommend doing so.  This may help him understand your desired outcome and he can further guide you in the implant selection process.  One of the key measurements is your breast base width.  If you select too wide of an implant, you may not have the best appearing outcome.  If you downsize the volume a bit, you may be able to use a moderate profile and it not be too wide for your frame.Good luck!

Brian Coan, MD, FACS · Answer

Thanks for your question about breast implant sizing.  I'd recommend you discuss first what is your ultimate aesthetic goal with your plastic surgeon.  After you share "wish pics" and discuss your desired outcome your surgeon will be able to best guide you.  Best to you.  -Dr. Coan

Justin West, MD · Answer

Hi and thanks for your question. I think you are right on with your thought process. High profile implants tend to give a less natural look, especially for patients who have not had kids or have not done breast feeding. For someone built like you, it's not unreasonable to consider HP implants. You very likely have a narrow chest and breasts with a narrow base width. In patients like that it can make sense to look at HP implants as an option to get you the volume you need without making breasts that are too wide. You have to decide what kind of look you want, and make sure you've communicated that very clearly to your surgeon. Show him or her pictures of results you like and dislike. The other thing to consider is to find a practice like ours that uses the Vectra 3D imaging system. This allows us to show you what different size/style implants look like on you. Good luck.Dr J

Robert Singer, MD · Answer

The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, 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, breast dimensions 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 suit
at a preoperative visit will help you and your surgeon choose the optimal
implant.

Keep in mind that following the
advice from a surgeon on this or any other website who proposes to tell you
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

Moderate or high profile for small frame?

Answers (14)

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