I'm petite (5'2, 100lbs). Using 200-225cc. What would produce a less fake look with silicone: mod+, or high profile? (Photo)

Question

Given my size, I've decided I want to stay under 225cc for a more natural appearance. I'm currently a 32AA, and I am not trying to achieve a really obvious appearance. Given my severe lack of breast tissue, I'm terrified of the "balls on a chest" look! Because of this, the high profile implants are scaring me a bit. Would a mod profile + help me achieve more of the look in Picture A than in Picture B (my desired result)?

Keith Hodge, MD · Answer

Thank you for the question. With your petite frame and your desire to look natural, I think that you are on the right track. I just performed a breast augmentation on Tuesday on a woman with a similar frame. She is 5'3" and 100 lbs with A cups. I placed the new Inspira 210cc moderate plus gel implants, and she couldn't be happier. The Inspira gel implants have a higher gel to shell ratio, so there is virtually no wrinkling which is important for thin women. I love doing breast surgery and making women feel better about themselves in and out of clothing! I would like to see you in consultation and show you the new Inspira implants. Best of luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

When placed behind the chest muscle, implants will have the most natural appearance. I believe mod+ will look a little more natural than a high profile.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and AuthorRealSelf Distinguished Hall of Fame Inductee

William Andrade, MD · Answer

Hello, the gap between implants depends to a large extent to your anatomy.  Your surgeon has to insert the implants under your breast mounds.  The use of one profile of implant over the other (moderate vs M+) doesn't guarantee there will not be a gap.  Your surgeon will help you to pick the right profile based on your breast width, tissue characteristics, and your desired size.

Martin Jugenburg, MD · Answer

Sounds like you are preparing yourself well for this surgery. The difference between the high profile and moderate profile is the shape of the implant. A moderate profile implant will give you a slightly flatter appearance from side to side where as a high profile implant will give you more volume towards the front of your breast. Both implants can give you a natural appearance it is more so dependant on your personal preference. Best of luck.

Joe Gryskiewicz, MD, FACS · Answer

Hi Ready,First and foremost the implant should fit the dimensions
of your breast and tissue cover. With a good fit, then it really doesn't matter much if you use HP or MP in this size range.  Here are a few tips
for you because this is perhaps the hardest decision for a patient to make, as
well as the surgeon.  Also see the video
attached to my answer.  Balancing the implant to your over-all body shape
and tissue cover is essential.The main thing is to have the diameter of the implant fit
the diameter of your breast "foot print".  The average size chosen over our last 7,000 breast implants was
“350cc”.  BUT, 90% of our patients tell us they wish they were
bigger a year after BA.  (We will see you
every year for routine checks at no charge.) It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
 You can try on implants in the office by
placing them into a special bra.  The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.  Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.  Keep in mind
larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than
saline implants, they might be your best bet.

You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and
see what you think.  Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
 Multiple measurements of your chest wall
are taken (seven in total).  Implant size
selection has been an issue of much discussion.

Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.  Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape.  A photo album of patient
pictures is maintained to assist them.  These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery.  In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.  Finally,
your verbal requests are factored into the analysis.

We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.  It is a surgical procedure that uses
special instruments and techniques to minimize tissue damage and avoid touching
the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published studies
of BA patients, 95-percent of women interviewed after the procedure returned to
normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.”  These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.

Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons).  Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year.  Be sure the PS has been in practice for a
while, about 20-years might be a good gauge. 
Does the PS offer all three incisions? 
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach." 
Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.   All the
best, “Dr. Joe”

Christopher V. Pelletiere, MD · Answer

Without examining you in person, it is impossible to say what will really be your best option.  Certainly, a moderate plus implant will provide a more natural appearance than a HP implant, but that may limit your voulme since the moderate plus style is wider than the HP in the same volume.  200-225cc is a very small implant, and will make a small change on your frame.  You should discuss both the volume and profile with your surgeon so that you can understand what will woprk best for you.

Victor M. Perez, MD, FACS · Answer

Shaped implants (gummy bear) or anatomical implants are probably the implants that will give you the best natural shape you are looking for. Be sure you get the advise from a member of the American Society for Aesthetic Surgery with experience in the use of this type of implants.

Gabriel Del Corral, MD, FACS · Answer

thank you for your question.  To answer your specific question,  yes,  a moderate plus profile implant will allow you to look and have it did desire natural result you're looking for.  There are 2 options when it comes to implants she can take in a teardrop shaped implant or a round implant in very thin patient's like yourself would favor a teardrop shaped implant for a better result.  Good luck with your surgery !

Levi J. Young, MD · Answer

Great job on how you're approaching your breast augmentation.  You are asking all the right questions.  I think looking at your desired photos you should get a very good and natural result.  The 225 is a small implant and will likely get you into a natural B cup.   For the most natural look I would agree that you avoid the high profile implant.  A moderate plus implant would be a good choice for you most likely.  Best wishes.

David Janssen, MD, FACS · Answer

In patients who are very petite and have very little breast tissue, I treat this similar to mastectomy patients in that I use a textured dimensional device.  Depending on your physical examination and desires, I would likely use a Sientra textured bidimensional device.  I use implants from Allergan, Mentor, and  Sientra in my practice and our Vectra computer imaging system allows us to show the difference between implants style and shape in you.  I would likely not use a smooth round implant in somebody as small as you because of the higher risk of rippling and fold flawing.  There is no guarantee even with a bidimensional device you will not have any rippling or fold flawing but I do believe it is significantly better.  Incidentally, only board certified plastic surgeons can use Sientra implants.  Cosmetic surgeons cannot use them unless they are  board certified by the American board of plastic surgery.  Read about this Sientra orange dot on real self.

I'm petite (5'2, 100lbs). Using 200-225cc. What would produce a less fake look with silicone: mod+, or high profile? (Photo)

Answers (15)

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