HP or Mod Plus? I have decided 500CC but can't decide on profile? Surgeon says I can go either way (Photo)
Doctor Answers 6
Hello and thank you for your question. You are a great candidate for a breast
augmentation. The size, profile, and shape of the implant is based on your desired
breast size/shape, your chest wall measurements, and soft tissue
quality. This decision should be based on a detailed discussion
with equal input from both you and your surgeon. This entire surgery can be performed with a
small incision technique. Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Hello and thank you for the question and the photo.
Based on your goal "dream" pic, I would suggest the HP implant. It is possible that even with 500 cc that your result might still not be as large as the last dream pic you showed. To best determine the implant size, I would suggest doing the rice test at home.
Take a pair of nylons, fill each with dry rice ( 1 ounce = approx 30 cc ) and wear that inside your bra for a day. It will give you a good idea of how much added volume will make you feel. To get to a 500cc size, you will need about 16-17 ounces per breast.
Your before pic shows a slight nipple position asymmetry. I believe that in the mirror, this is the right nipple that is lower. I would caution you to know that after implants, this nipple position asymmetry will be MORE obvious, not less. It's not a bad thing, but something you should be aware of.
The general rule with implants:
1. if there is a slight size difference, implants will make the size look more even.
2. if there is a slight shape / nipple position difference, implants will sometimes make this worse or more obvious because the result is magnified.
You should have several consultations with board certified plastic surgeons before making any final decisions.
As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md.
Best to you.
High profile vs. Moderate Profile
Thank you for your question.
The profile of the implant basically dictates how much the implant sticks out in the forward direction and by how much the overlying breast skin is stretched.
There are low, medium, medium plus, and high profile designs for both round and shaped implants.
When you increase the profile of the implant within an implant of the same volume, you are essentially decreasing the diameter and increasing its outward projection (height) giving it a more ball shape.
- Low profile implants have wider diameter and the lowest projection
- Moderate profile implants have less projection because of their wider diameter
- High profile implants are narrower at the base and consequently have more projection
High profile implants do generally provide a fuller look in both the upper and lower pole. This is why breasts would appear to be more rounded and augmented rather than natural. A natural look implies a slope in the upper pole, and a curvature in the lower pole giving the breast distribution ratio of 45:55. Whereas, with high profile implants, you may get a 50:50 ratio. If you want to avoid top heavy look, then go for the moderate plus profile. However, from your wish pics, it seems as though high-profile implants would best help you achieve those results.
That being said, your chosen profile must be tailored to your breast characteristics and measurements.
If your breast width is small, then a high profile implant will be necessary to provide a better distribution of volume within the breasts. If you have a wider breasts, then you may require low to moderate profiled implants to avoid the “rock in a sock” appearance.
Also note that even if you do get high profile implants, having them placed under the muscle is more beneficial compared to over the muscle placement as the latter comes with increased risk of breast tissue wasting.
Hope this helps.
Best of luck with your surgery!
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Can't decide on breast implant profile?
Thank you for the question. There are several steps taken to select a specific size/profile breast implant for a specific patient. The difference between the different profiles of breast implants available have to do with the dimensions (diameter and height) of the implants. For example, the high-profile implant has a greater projection and a smaller diameter compared to the moderate profile implant. The moderate plus profile implant as projection and diameter characteristics that fall between the moderate profile and high profile implants.
I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
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/video, dedicated to breast augmentation surgery concerns) helps. Best wishes.
As you know, high profile implants have a narrower base. Generally speaking, in the 500 cc range, most women have a chest width that requires a high profile implant. If your surgeon has used your chest width measurements and feels comfortable with either, then I would proceed with the high profile. If the width isn't big enough for a mod profile you can see some folding of the implant.
Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery
I appreciate your question.
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. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.
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 liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
Anatomic gummy bear implants might be a good choice to give you volume.
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.
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.
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!
Board Certified Plastic Surgeon
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.