Moderate profile vs. moderate plus

Question

Hi doctors! Quick question-is there much of a difference between moderate, and moderate plus, projection wise? I have heard it is millimeters of a difference. I know moderate is the widest the come (I have them and love them), but I was just wondering as a friend is considering a BA. Thanks so much!!

Daniel Barrett, MD · Answer

Dear Momoftwo18,you are right regarding the projection. Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, 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 it is 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, every one of them has 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.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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. Implants that are wider than this can be more palpable, fall more laterally overtime and also be more palpable. After that we will then choose the implant volume based on the measurements and also looking at any asymmetries you might have. 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 peoples bodies and your results will probably be different.
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 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, 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.
 Implants, indifferent projections. The easiest way to think about it is they called me in a low medium and high projection or profile. Most of the time I use the medium profile which gives people the best in terms of natural look as well as a little bit of projection. High profile implants are for someone that wants  A little bit more of a fuller look. Low profile implants are better for someone that really wants a minimal extremely natural augmentation. Depending upon the anatomic versus round implants there are also subtle differences  in terms of the amount of projection for each profile. 
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 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.
In order to limit pain from breast augmentation and speed the recovery process I offer patients Botox into their muscles as well as a long acting numbing medication called exparel. 
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

Robert L. Steely, MD, FACS · Answer

good morning!yes- profiles do matter- but the dimensions of the implant have to be a good fit for your body in relation to the volume being used.  There is a 2 cm difference in projection (almost an inch) between a 300cc moderate classic and an ultra high profile Mentor implant- but the highest projection is not  the best choice for everyone- your tissue and chest wall characteristics need to be taken into account to get the best result.  Being able to evaulate these differences is why going to a board certified plastic surgeon with lots of implant experience is vital to an optimal result.I hope this helps

Jonathan Heistein, MD · Answer

Hi.  This is a very common question.  The differences are small but each implant size fits differently on each individual.  It is important to make sure the width of the implant fits the width of your chest but there are variations that can change the look even within these guidelines.  Your friend should go for an in-person consultation so that she can try on the different implant sizes and profiles and figure out which one looks best on her.  Best of luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

You are right. In general, there is a small difference in projection with implants of the same size. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I do this with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them. 
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Scott E. Kasden, MD, FACS · Answer

Hi Momoftwo18There are many "profiles" available, especially when you consider that several manufacturers with offerings.Think of implant dimensions simply, as I do.  Each round implant has a diameter and a projection.  The designation of low, moderate, high profile, etc., is basically a description of the relationship of projection to diameter is altered.To put it another way, if you have a constant volume of say, 500 cc's,  the projection will increase LP>MP>HP, while the diameter will decrease LP>MO>HP.  That said, the proper diameter for the chest wall must be used for the best result.  So, if you need say, a 13 cm diameter implant, it is important to understand that you will need a larger implant if going from LP to MP to HP in order to achieve the same diameter.Therefore the difference in MP vs. HP projection must be judged according to like diameters, and usually is a few mm.  This can be a substantial difference even though not measured in inches.Hope this is clear, and helps.sek

Eric Mariotti, MD · Answer

Every implant manufacturer has many sizes and many styles with many different softness or firmness which means there are a bazillion choices. How does someone figure out whether they should get Moderate, Moderate plus, high profile or Ultra high profile?   It would make it much easier to understand if they called it widest, wide, medium width, narrow or very narrow. Then a lady could understand what might fit her the best. If you put a wide implant in a narrow chest you just have to bunch it up into the space.  If you put a narrow implant into a wide chest, you might not get the best cleavage or fill up the breast pocket.  Let your doctor figure out which one is the best answer I could give.

Tom J. Pousti, MD · Answer

I think that you have a good understanding.  Assuming the same volume of breast implant, the difference between moderate profile versus moderate plus profile breast implants (when it comes to projection and width dimensions) is a few millimeters. 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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
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. I have found that the use of words such as “natural” or "C or D cup” etc may mean 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.  The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 I hope this helps. Best wishes

Moderate profile vs. moderate plus

Answers (8)

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