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?

Semih Yildiz, MD, FEPOBRAS · Answer

Your photos show a narrow frame with small, deflated breasts after breastfeeding and some mild skin laxity. With an 11 cm breast width and a goal of an elegant, natural result, the most important issue is choosing an implant whose base width fits your chest. The profile label matters less than the actual implant dimensions.

A moderate profile implant can look natural, but in a narrow chest it may become too wide if the volume is pushed too high. A high profile or moderate-plus implant can sometimes be the better choice because it allows more volume while keeping the base width narrower. High profile does not automatically mean an obvious or fake look; the unnatural look usually comes from choosing too much volume, too much upper-pole fullness for your tissues, or an implant that does not match the breast envelope.

Based on your photos, you may be able to get a nice improvement with implants alone, but the surgeon should also evaluate nipple position, lower-pole skin stretch, and whether a small lift would be needed to avoid a low or bottomed-out look over time. For an 11 cm base width, the right size is often in a range rather than a single number, commonly somewhere in the low-to-mid 200s up to around 300 cc depending on the implant line and your tissue measurements. I would choose the implant by base width, projection, tissue coverage, and sizer/3D simulation rather than by cc alone.

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.

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

Answers (19)

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