Switching Implant Profile? (photo)

Hi Norcalgirl,

     You have a notable amount of asymmetry.  Your left breast seems to have adequate upper pole fullness for its size.  Any more upper pole fullness would require a larger implant.  Your right breast, on the other hand, seems to be positioned lower overall, but the implant, itself, is also sitting a bit too low and lateral.  Correcting the implant pocket will give you a bit more symmetry.  It also appears to me that your right shoulder being a bit lower than your left suggests some mild scoliosis.  Therefore, your best symmetry will come from closing the pocket on your right and lifting your right breast.  However, a lift requires additional incisions which may not be worth doing.

     As far as implant choice, high profile implants produce the most upper pole fullness.  I am not sure why your PS is suggesting textured implants.  I see no advantage of using a textured implant behind the muscle.  They actually have a higher rate of rupture as well as more rippling even with silicone.  The texture will not keep the implant sitting higher.

Good Luck,

Ary Krau MD FACS

 

 

The normal breast doesn't have the maximun upper pull. If it did it would look odd and wouldn't be an attractive breast... Upper pull is maximized with a high profile implant. Speak with your plastic surgeon and go over all of your options. In my opinion switching to a high profile implant will yeild the results your desire .

When doing a revision you need to address the things you don't like or that you do like. If you like your width you need to stick with an implant of similar width but a higher profile.  If you use the same profile but larger  cc's you will not be any rounder on top.  You have marked asymmetry which will probably be best corrected by changing both breasts a little.  You should discuss with your PS which breast you like better and try to match that one.

Upper pole fullness is enhanced by submuscular placement. larger volumes and fullness higher on the chest. You have not mentioned a change in volume. For the same volume, high profile implants stick out more; however, they also have a narrower diameter and do not reach as high. The limit for increasing diameter is more the width of the breast than the height.

Your breasts sit lower on your chest, so the simplest fix is to wear a bra. Surgically moving the implants up will leave the nipples low, so a lift would be needed to raise the implants and keep the nipples on the front of the breast. This will also allow for more complete correction of your asymmetry. A lift means more scar on the breast, so there is definitely a trade-off.

You should consider getting another in person consultation, as it is not a good idea to make surgical plans based only on pictures. A full history and physical exam are needed. 

I agree you need revision of your breasts to achieve symmetry.  Switching to high profile implants will probably only make a slight difference in upper pole fullness and might not be worth the cost of new implants if your surgeon feels your implants can be reused.

Thank you for the question and photos!  I hope that these answers help you!  I do agree that you have some asymmetry between your two breasts along with a difference in size.  I do not totally agree that changing the profile of your implants will completely meet your desires.  Changing implant profile will serve to increase the projection of your breasts and have minimal, if any, change in upper pole fullness.

 The most important determinant for breast implants is the breast width.  Matching an implant to fit correctly for you breast will give you the best aesthetic results.  Since you do appear to have a very long torso, it may be difficult to get an implant to accomplish this for you, unless you used very large implants.  Other options may including raising your fold during your revisionary procedure, or performing a small lift or some fat grafting to the upper pole to ameliorate this issue.   Evaluation and examination by a plastic surgeon will help to assist you in determining which procedure(s) may be the right one(s) for you.  Best of luck!

 

I do not think anything as simple as changing profile will cause a significant difference in upper pole fullness. If you want more superior pole fullness you will probably have to go to very large implants. Your current shape is very natural, and more fullness superiorly with your size would not be natural. Your asymmetry is more complicated, and I think you need to understand you will always have some asymmetry, and it is natural.

Simple answer is that changing the profile of the implant will do NOTHING for upper pole fullness. You have asymmetrical ptosis. To fix the lack of upper pole fullness you would either need a breast lift or the placement of massive implants (last one NOT recommended).

If you measure the normal base width of each breast and decide what VOLUME you want to be, then the profile that matches these two things best is the one to use. The profile therefore selects itself! SO FORGET ABOUT PROFILES!

Better not get involved in the technical details of the surgery: concentrate on how you want to look. Remember, if you tell your surgeon to change the profile of your implants, it is not his/her fault if the result is not what you expected: the surgeon simply carried out your orders. However, if you ask for a full upper pole, elevation of nipples, correction of asymmetry etc. then it is up to the surgeon to make these things happen. This is a much better situation for the patient.

     The main issue for creating upper pole fullness is to have a pocket that is tight and allows the implant to assume its full height.  If the implant is sized appropriately then a high profile implant may provide for more projection and some increased upper pole fullness.  Kenneth Hughes, MD Los Angeles, CA

The problem with using a smaller implant is that the base diameter will be much smaller and the implant will move laterally in the pocket. To use a new implant you will need a site change or a neeopocket, in this case going to a smaller implant may help you. If you use a shaped implant you will also need a site change. Discuss your concerns with your plastic surgeon.