What breast implant type, placement, and profile is best for longevity?

I have desired implants since I was 16. I have always lacked fullness at the superior of both breasts. Also, my breasts are usually the first to go when it comes to weight loss and post pregnancy. I am now 26, 5'6" and 140lbs with two children (under 4 y/o) and need a product to withstand their antics. I am also a DIY'er of large/heavy products and definitely accident prone. I want superior fullness as well as symmetrical fullness overall and an increase from B cup to D (or DD if needed).

Doctor Answers 10

What breast implant type, placement, and profile is best for longevity?

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Thank you for your question.  A submuscular breast implant placement is preferable for longevity of result, better coverage, and less risk of capsular contracture.

Sizing and choice of profile will depend upon your examination by your plastic surgeon.  The base width of your breast is the most important measurement done to determine size of implant that she will require.  To learn more about different implant profiles please read the link below:

Implants Are Robust

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The goal of breast surgery is to create an aesthetic breast with the size, shape, and projection that is desired by the patient. During a breast surgery consultation, measurements of the breasts are used as a starting point to recommend a breast implant.  The decision on size, shape, and position of these implants is based on the patient’s anatomy and the type and size of the implant and patients preferences. The need for a lift is determined by your current nipple position and the quality of your tisssue.

All the implants are robust products made to withstand the abuse that breasts go through. Based on your description, a dual plane smooth round silicone implant with a lift would likely give you a nice result and still allow you to continue to be active with your children and to pursue your DIY adventures. 

See the link below for more info on breast augmentation and breast lifts. 

A detailed examination will help delineate the best surgical treatment. In office sizing and digital three-dimensional simulations can help guide your implant choices. Consultation with a plastic surgeon certified by the American Board of Plastic Surgery would be the next best step.

Breast Augmentation - Size Selection

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Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Breast implant type

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There are many different implant styles and types. It typically is best to see pictures or see the patient in person to give the best advice. We do offer virtual consults which can give you more accurate advice. Please consider emailing us for more information. 

William J. Hedden, MD
Birmingham Plastic Surgeon
4.8 out of 5 stars 334 reviews

Photos for advices

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Thanks for the question.

I recommend you to send your photos to us to give you the advices you want and need.

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 369 reviews

What breast implant type, placement, and profile is best for longevity?

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Both saline and silicone implants have very good safety records and will withstand the types of trauma that you describe easily. It actually takes quite a bit of force to rupture an implant. Most ruptures/deflations are actually caused by the implant shell cracking due to rubbing together, not from trauma.

The specific type and size of implant is best determined during a personal consultation as there are many factors that affect the determination of implant size and profile.

What breast implant type, placement, and profile is best for longevity?

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Thank you for your question.  Unfortunately nothing replaces an in-person examination but I would favor the placement of silicone implants underneath your chest muscle at a size that is just smaller than your breast width.  Depending on your desired goal appearance, the best profile, size, and need for ancillary procedures can be determined during your in-person consultation.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

What augmentation is best for longevity?

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With our experience over decades we have seen the best augmentation for longevity, which we mean as good looking and feeling results after 20 years or more, come from a moderate profile smooth submuscular saline implant of a moderate size, say 360cc or less, properly filled. This is the safe and sure, low capsule rate, low show-through, low hassle, and easy replacement solution. This of course might not be the solution for you depending on your goals or might not meet your definition of longevity, Enjoy your search for the best you.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Achieving longevity in results after BBA

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Thank you for your question!

Having a breast augmentation can be a difficult decision especially when there are so many options and many conflicting opinions.

However, you have to realize that long-term results and satisfaction is based on your preferences and desires. So although some options may offer longevity of the results, they may not be the results you are hoping for. For example, the dual plane or submuscular breast augmentation is preferred to offer long-term aesthetic looking breasts. However, they are more likely to provide a natural 45:55 upper pole to lower pole ratio, whereas, you may be hoping to achieve more upper pole fullness (50:50 ratio). Having the implant in the subglandular position (over the muscle) better addresses goals to achieve upper pole fullness. So longevity of the results has to be applied to what you value and desire.

As such, you may need to have an in-person consultation where the implant, the placement, and profile is tailored to your breast measurements & characteristics, and to your preferences.

That being said, let me provide some information to help you in the process.

You should choose a surgeon you trust, who gives value to safety, and who does not rush you. They shouldn’t necessarily agree to everything you say either because you wouldn’t know what is best for you, so it the job of us surgeons to guide to make decision that will minimize complications and allow you to have beautiful breasts. So you must verify their skills, education, and certification. Ask about your surgeon’s experience about the procedure you want and ask to review photographic examples of your surgeon’s work. Check to see if the aesthetic ideal is consistent with what you are hoping to achieve. Make sure the before and after images have the same perspective, the same lighting.  Read the surgeon’s reviews for the procedure you want.

What should matter most to you is that implant you choose looks good aesthetically and is comfortable and proportional to your body. This means not to focus on achieving a specific cup-size. If you seek a board-certified plastic surgeon, then they will assist you in choosing an implant that is more tailored to your breast characteristics. Surgeons use what is called tissue-based planning. The planning takes into account the effects of implants on tissues over time, risks of excessive stretch, excessive thinning, visible or palpable implant edges, visible traction rippling, ptosis (Sagging), and breast tissue wasting.

To determine the implant size, breast measurements must be made: 1) Base Width of the existing breast tissue, 2) breast skin stretch, and 3) Nipple-to-Inframammary Fold distance. The combination of these measurements will help determine tissue coverage and the required implant volume to optimally fill the breasts.

The fifth generation implants of today are highly durable, and have very low rates of device failure and they come in various shapes, textures, profile and sizes. You may most likely go with a smooth surfaced, round implant as is preferred by many surgeons. Since you want more upper pole fullness, you may desire a high-profile implant.

It is important that you communicate your goals very clearly, but understand that you need to have realistic expectations.

Hope this helps and best of luck!

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 520 reviews

What breast implant type, placement, and profile is best for longevity?

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Thank you for the question.  All currently FDA breast implants are very durable. In my practice, the type (saline versus silicone gel) of breast implant utilized is individualized mainly depending on the patient's starting anatomy and goals.  The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.  

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 "D or DD 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, dedicated to breast  augmentation surgery concerns) helps. Best wishes.


These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.