37yo mom with deflated breast- high profile vs moderate? (Photo)

Question

Hello, I’m 37 5’7 128Ib, breastfed 3 kids and currently with deflated cup A (I attached some pics). My breasts width is 11cm if it helps, so I’m pretty narrow. I’ve been to couple consultation and left a bit confused. Some say moderate is best and 2 other recommended strongly on high profile. My goals is something to fill up the volume with elegant natural look. Any advice? And also what would the ideal size cc wise?

Daniel Barrett, MD · Answer

Dear rev2805,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thanks for your question! Because you are so narrow, I'm inclined to recommend a full profile. However, trying on implants in office is the best way to determine the size/profile you should choose for you. Good luck!

Azita Madjidi, MD, MS, FACS · Answer

Natural look for breasts is a flat top and round bottom. High Profile implants will give you a push up bra look which is not natural. If you want to just restore the fullness without having the roundness on top, then a mid range or Moderate Plus look will give you that look. You can find on the catalogue to what cc it corresponds to. The cc does not matter as long it creates the shape that you like.

Martin Benjamin, MD, FACS · Answer

Hello! It really just depends on your aesthetic. A full profile would give you slightly less cleavage and upper pole fullness while providing you with greater projection and really filling out the deflated skin. A moderate profile would increase your cleavage and upper pole fullness but would not provide you with the needed projection. Considering you may benefit from both, you may want to consider a moderate-high which is a good middle ground implant that would help provide you with both. Good luck!

Ira H. Rex III, MD · Answer

I think either profile would suit who you well. there is less difference than patient's usually understand.  you seem to be considering fairly small implants, and so the difference in shape would be minimal.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Carlos Marciales, MD · Answer

Hello, I would recommend moderate 300 cc implants, if you want to look like the photos with the desired results.

Gerald Minniti, MD, FACS · Answer

Any given implant profile is not better or worse than another profile; they serve to complement the patient's breast tissue and allow for adjustment of volume for any given implant diameter. Your breasts have little projection or soft tissue volume and will simply serve as a thin cover over the implant, so the shape of your breast after augmentation will have virtually the same shape as the actual implant.  Get a good consultation where your anatomy is measured to determine implant dimension limits, then get sized or have 3D simulation software to determine implant size. When it comes to implant size versus how your breasts look naked ('natural' versus 'fake'), size will determine your happiness after surgery. Fortunately, your idea of 'natural' based on your goal photo will not be much different from the result I envision for you. *******One important caveat******* You will have implant malposition if the surgeon is not experienced enough to recognize a substantial difference in your soft tissue envelope (your breasts). Your wider, saggier breast will allow the implant to drop out if not managed correctly. What that entails would be determined based on physical examination, not photos.

Gary M. Horndeski, MD · Answer

Your breasts are asymmetrical in volume, shape and position. You would benefit from a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ram Kalus, MD, FACS · Answer

Thank you for your excellent question and photos, and sorry to hear you are confused, but that is understandable. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (300 versus 400), is far less significant than implant width and projection, both of which relates to “profile”. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. If you have enough native breast tissue a Moderate or Moderate Plus should suffice since the diameter of the implant and volume will fill out a rounder full breast that is more natural. The volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. It is true that for a given volume a higher profile implant will have a narrower diameter, and it is also true that a person such as you with a petite frame will require a narrower diameter implant than a patient with a broader chest or larger frame.  Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

37yo mom with deflated breast- high profile vs moderate? (Photo)

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