Moderate Vs High Profile? (photo)

Question

I was set on Moderate Profile Silicone implants. When I went to my preop I was told that HP implants would be a better option for me due to my smaller chest wall. I have a gap and that is why I wanted to go with the moderate profile due to the wider base of the implant. I do not want high round fake boobs and I feel that I will get that with the high profile. I am also getting a vertical lift with my augmentation. I would greatly appreciate your opinions regarding the profile for my body type.

Tim Neavin, MD · Answer

Thank you for the photos.  I do not prefer HP implants.  They look less natural and produce less cleavage, even in thinner women.  In fact, virtually every woman who has had a HP implant and desires a change in size tells me they didn't like the HP look.  Women want cleavage.

Brian C. Reuben, MD · Answer

Thank you for your question and photo. This is a very common question and some patients can be very torn over what is their ideal implant. As most surgeons will point out, the high profile implants give more "fullness" or volume for the given width of the implant. Choosing the right implant is something that you and your surgeon should discuss in great detail before surgery. Your surgeon can then pick the right implant for you based on how much tissue you have, and the appearance you are going for. The position of the breast on the chest wall or the breast "footprint" will not really be changed by getting a wider implant. Simply stated, a wider implant will not make the breasts appear to be closer together. You have significant volume loss to the breasts and sagging (or ptosis). A lift is important, but placing an overly wide implant will not necessarily give you a fuller breast. I would worry less about the high or moderate profile of the implant but focus more on discussing with your surgeon your goal cup size and breast shape and they can then help determine which implant will be most beneficial for your situation. Best of luck!

Adam Tattelbaum, MD · Answer

Thank you for your photo and for your question. High profile implants project more than moderate so for implants that are the same width you can get a larger cup size. You can choose the same diameter high or moderate.
	Clevage is mainly a factor of your starting situation if the implants are placed under the muscle. They should go no further toward the middle than the insertion of your pectoral muscle or you can develop synmastia or breadloafing. Because you are so slender under the muscle would make the most sense to me.  Over time the muscles push implants outwards, so clevage depends on your bra too.
	Based on you photo silicone makes sense because you are so slender. Moderate profile implants tend to look more natural than High profile.
	I believe based upon your photo that you will need a breast lift.  Your surgeon may be recommending the high profile because high profiles give more tissue elevation, hence less lifting. With a moderate profile you may be better of with a full, not vertical only lift.
	I recommend that you look at sample implants in a testing bra on your frame. Think about the width first and how it fills the chest wall and balances with your hips.  One you find the diameter that compliments your hips nicely then play with the moderate or high projection an see which one satisfies your goal for cup size.  One you have the implant in mind that best achieves your goals your surgeon can re-evaluate what degree of lifting you will need and which type of lift may be best.
	 
	Best wishes.

Michael Horn, MD · Answer

Hi. when the same width, the high profile implant has more projection (pushes your nipple further out from your chest) and is 100cc larger in volume. So for the same volume implant, the high profile has a smaller width. So, although the name is high profile, they go less high up from the front view. The way to avoid a large gap is to choose an implant close to the width of your natural breast. I like to use 3D imaging to show patients in the office approximately what each implant will look like. A picture is worth a thousand words.

Moises Salama, MD · Answer

This is a great question. The profile chosen for the implant is based on the breast width, chest width, goal of the patient, and surgeon preference. High profile implants obviously give more projection but they do not give as much cleavage, upper and lateral fullness as moderate profile implants do. I prefer moderate profile implants for most patients because I like their ability to enhance cleavage. You should discuss your goals with your surgeon to see if you prefer more cleavage or more projection.

Kenneth Hughes, MD · Answer

I frequently have to switch to high profile implants to meet the volume needs of the patient for those patients with smaller width chest walls. At some point, a high profile implant makes more sense to fit your dimensions. You can always go with a smaller moderate profile implant but you cannot have a larger moderate profile implant wider than your chest wall. Kenneth Hughes, MD Los Angeles, CA

Richard Wellington Swift, MD · Answer

Communicating your breast augmentation and uplift goals with your plastic surgeon is paramount pre-operatively. Judging from your photograph it appears that Moderate Plus Silicone Implants with a breast uplift will give you the best outcome. The Moderate Plus implants are designed to have more projection than the moderate implants and they are wider than the high profile implants. The Moderate Plus implants will give more fullness and cleavage than the moderates, without the "fake" upper pole fullness of the High Profile implants. Because of your skin laxity you will require an uplift. Your Board Certified Plastic Surgeon will be able to select the correct size and volume (cc's) of your moderate plus implants once you are examined. During surgery, your plastic surgeon can use different breast implant sizers to determine your optimal breast implant size. Good luck with your surgery. Dr. Richard Swift

Maria Cristina Picon, MD · Answer

I need your profile picture, but look as you have good pectoral muscle, if you have it, the high profile could over correct the upper pole.

	 

	Spanish translation provided by doctor:

	Necesitaria su foto de perfil, parece tener buen volumen de pectoral, si asi fuese, con un perfil alto, se podria corregir en exceso.

Pablo Prichard, MD · Answer

Hello and thank you for your question.

	In choosing an implant, it is important to choose the base width of the implant first.  This is equal to the distance from where the breast starts on the sternum, to where the breast stops on the edge of the chest.  The thickness of your breast tissue is then subtracted from this number.  This is how your implant base width is chosen.  Where the breast starts on your sternum will define how much of a gap you will have.  Some surgeons are less agressive with this and use the actual starting point of your breast rather than the ideal starting point on your sternum.  Being less agressive will give you a bigger gap between your breasts, however, there is less chance of rippling as your tissue may be thinner closer to your sternum.  If your tissue is thin over the sternum, the rippling can be prevented or improved by using a dermal matrix (an extra layer of tissue) to thicken the area.  Once the breast width is chosen, then projection (moderate, vs. moderate plus, vs. high profile) is chosen.  This projection defines cup size.  So giving your surgeon your goal of cup size helps him/her choose the correct projection. 

	Best Wishes!

	Pablo A. Prichard, MD

Pedro M. Soler, Jr., MD · Answer

The lift will elevate the nipple areolar complex along with the ptotic (drooping) breast tissue. The implant will add voume and give fullness to the superior pole that the lift will not provide by itself. It is very important that the implant chosen is not of a larger diameter than that of your breast, which has already been defined by your anatomy. The high profile implant will give you more projection than a similar volume moderate profile implant at a smaller diameter. Therefore high profile implants are good for patients who need more volume in a diameter that a moderate profile implant cannot provide for a similar volume.

	In any case I would recommend that you revisit with your plastic surgeon and discuss your concerns with them prior to your surgery, this should help put you more at ease. I hope this helps. Best of luck.

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