One doctor recommends high profile breast implants the other says moderate - I want natural results.

I am 5' tall 100lbs minimal breast tissue 28in rib cage. Consulted with two surgeons. One recommends 225cc High Profile Implant because I'm tiny. Says small diameter will fit better under my own breast tissue. Other surgeon is recommending a larger/flatter implant (275cc Moderate Profile). Says too small of an implant will look like I have baseballs under my skin. I am totally confused. I want a verrrrrry natural looking result. I don't know which surgeon is going to get me the look I want.

Doctor Answers 16

One doctor recommends high profile breast implants the other says moderate - I want natural results.

The answer all depends on your anatomy and measurements, but as others have stated, high profile implants have a narrow(er) diameter and more projection, whereas moderate profile implants (of the same size) have more width and less projection, usually leading to a more close cleavage (no wide Grand Canyon as sometimes seen with HP implants that are too narrow), and a more natural look.

BTW, round implants (at least in patients without capsular contracture) are teardrop-shaped when the patient is upright, and flatten out and drop slightly to the side when reclining, which is exactly what natural larger breasts do. So-called "anatomic" teardrop-shaped implants are textured (to adhere to your tissues) since they must be placed and stay in the precisely correct position (upside down would look pretty weird, don't you think), and therefore remain teardrop-shaped when reclining, as well as not moving or flattening (pointing straight up is "natural"--NOT), and are more firm, require a larger incision for placement, and cost more. Wow, all that for LESS natural?

And with respect to Dr. Hodge, HP implants are narrow(er) in both horizontal AND vertical dimensions (since they are round), and therefore do NOT give more upper pole fullness once they are in their "final" position--they just have upper pole fullness early on in the recovery until they drop, and then they can have too-wide cleavage and too-little fullness superiorly! NOT natural. Not really baseballs, but more like that than the moderate profile implants.

So, if the slightly larger round smooth moderate profile implants "fit" your breast base diameter, I believe you will have a better and more desirable result with these implants. If they are too wide for your base, but you still want that size, you may need to go to moderate plus, or even the HP implants. But in general, choose the desired size first, go slightly larger to accommodate for submuscular compression, and then choose the widest, lowest profile that fits your size and width parameters. You may need a "tie-breaker" in-person third consultation rather than competing online recommendations, and you may want to read my Comprehensive Guide to Breast Augmentation by clicking on the web reference link below. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

The most natural result is no implant

I am a little confused. Of course you want a natural result. However, you are disappointed with the natural result that nature has given you.

"Natural" results for Patient A may be too small or too large for Patient B.

Natural is the cover of National Geographic.

I think it would be better if you said you want a subtle or a not an obvious result. However some patients might be disappointed with a "natural" result that is too small and they feel as if they didn't get what they paid for.

I suggest

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

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!

Dr. Schwartz

Board Certified Plastic Surgeon



Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Shaped cohesive gel implants provide the most natural looking long term results

225 does seem small even for a five foot , 100 lb girl unless you want a very small implant. 

A shaped , teardrop, cohesive gel will look the most natural. Round implants in small thin people may look fake.

The implant should fit the width of your chest, a measurement we do not have from you to make a recommendation. That would be in cm, and ranges from 10 to 19 cm. The implant is usually 1.5 to 2 cm narrower and then the projection determines the final size.  Some patients want a larger size and as long as it is a teardrop it still looks natural.

Get a third opinion to break the tie. It is cheaper than being unhappy with the result

Benjamin Van Raalte, MD
Davenport Plastic Surgeon
4.7 out of 5 stars 42 reviews

One doctor recommends high profile breast implants the other says moderate - I want natural results

The interpretation of "natural looking" varies greatly from patient to patient and from surgeon to surgeon.

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: your individual anatomy, desired outcome, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Implant selection

Hello and thank you for your question.   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.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews

I want natural results.

The word natural can mean so many things, and it is important to let your surgeon see just what you wish to look like. Use photos, trial bras to give a picture of what you expect. Our bias to "natural" is a moderate profile implant to flow and blend well with the breast.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Breast Augmentation

Different implants produce different results.Also your preexisting anatomy has an effect on the final result.Computer imaging would be useful for you to see the options and how the results vary with different implants.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

One doctor recommends high profile breast implants the other says moderate - I want natural results.

Realize that it is difficult to make a precise recommendation without seeing photographs and preferably having an examination of you in person, but when I hear someone say they want a more natural look mid profile or mid-plus profile immediately comes to my mind.  Make sure that you and your plastic surgeon are comfortable with your final decision based on your consultation, discussion and review of photographs of other patients.  Good luck and best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

One doctor recommends high profile breast implants the other says moderate - I want natural results

normal breast are not narrow based and pointy, that is what high profile implants look like. I think maybe a moderate plus is a good compromise if you want a certain volume and you are limited by your breast width

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

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.