Pros and Cons with High Profile 475cc and 550cc under the muscle?

Question

I am 5'8, 135lbs. I'm a 34 A now. I have had three children, breast fed one (my other two were twins). So I have gotten up to a C cup and back down to an A. So I've been debating with two different sizes, 475cc and 550cc, under the muscle, high profile. I would like to know the pros and cons with these two sizes? I don't want to be the woman that regrets not going big enough but I also don't want to have any complications in the future if I can avoid them from the start.

Robert F. Centeno, MD, FACS · Answer

Thank you for your question.  High profile implants work well in small framed women to avoid the implant sticking out on the side and to give better medial cleavage.  It gives the breast a fuller rounder look if desired.  It may also help to fill in a breast skin envelope that is somewhat loose.  It takes about 50 cc's to even notice a difference in size, so a 75 cc change is negligible as long as the implants fit your breast and body well.  The submuscular approach as a lower risk of wrinkling, palpability, capsular contracture and malposition.  Best wishes!

Gary M. Horndeski, MD · Answer

At
size 34 A each 100 cc’s of implant corresponds to 1 cup size change.  475 cc or 550 cc implants are so large they
will not fit retro-pectoral, will extrude inferiorly and laterally requiring
revision.  Since you have had
pregnancies, it is most likely that you have some stretched skin envelope and
some drooping.  I recommend a new
technique called Breast Augmentation with Mini Ultimate Breast LiftTM.  Using a circumareola incision it is possible
to reshape your breast tissue creating upper pole fullness, elevate them higher
on the chest wall and more medial to increase your cleavage.  Through the same incision, implants can be
placed.  Aligning the areola, breast tissue
and implant over the bony prominence of the chest wall maximizes anterior
projection with a minimal size implant. 
Small round textured silicone gel implants placed retro-pectoral look
and feel more natural, are more stable, less likely to ripple or have
complications.  In the retro-pectoral
position, the profile of the implant is irrelevant since the muscle compresses
it and determines the projection. 
Approximately 22% of women who undergo breast augmentation require
revision within 2 years.  The best
technique to avoid revision is to avoid large implants.Best Wishes,Gary Horndeski, M.D.

M. Scott Haydon, MD · Answer

Thanks for your question. Given your height, I agree that your implant volume will need to be more that someone who is only 5' tall. Hopefully your plastic surgeon has measured your base width and discussed this with you. I do not use HP implants in primary augmentation because they look much rounder and more "fake". In addition they have more tendency to cause compression of the gland and can lead to severe rippling. As implant sizes increase, the risk of implant malposition and asymmetry goes up significantly. This translates into a higher risk of reoperation for correction. My suggestion would be to use a Moderate Plus Profile implant that is a slightly smaller volume. In the long run, you will be happier. Best of Luck!

Tom J. Pousti, MD · Answer

Ultimately, careful communication of your goals, careful measurements (dimensional planning),  careful selection of appropriate breast implants and skillful execution of the procedure will be important steps in achieving your goals.
 
Generally speaking, the best online advice I can give to ladies who are considering  revisionary 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're 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. I have found that the use of words such as “natural”  or “C or D cup” or "fake look" 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.

The use of computer imaging technology may also be helpful to patients;  this technology allows patients to visualize what their breasts may look like with different sizes/profiles of breast implants. I have found this modality to be a nice addition to the communication “tools” available.
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.

I hope this (and the attached link) help.

C. Bob Basu, MD, MPH, FACS · Answer

Thank you for your question.   First, there is a slight difference in projection and width between the two different implants you asked about.  In terms of sizing for you, there are several things that are considered for selecting the size for you.  I consider two factors when selecting implants for my patients:1.Dimensional planning2.Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.Best wishes,Dr. BasuHouston, TX

Curtis Wong, MD · Answer

Its a hard choice but the general rules are, the larger the implant,  the more likely you will have issues down the road that may be implant related and necessitate a revision and even possible downsizing... yet the most common complaint I hear is "I wish I went a little larger".  So my suggestion is to go for what you really want and live your life to the fullest... and deal with any issues down the road should they occur.  As for profiles, I select them based on patient measurements and goals.  I do not simply choose a profile just because a patient may want them.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  High profile breast implants under the muscle are often recommended for petite thin framed women.  However if you 1 maximum cleavage and lateral fullness a moderate profile plus is a better option.In my experience 550 cc is a very large implant, often does not look natural, and can lead to increased chance of complications.  475 cc's the larger range that I typically use in my practice although West Coast surgeons often go bigger.

Pros and Cons with High Profile 475cc and 550cc under the muscle?

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