High Profile vs Moderate Plus? (Photo)

Question

I'm 5'3, 112 lbs and petite. I have seen 2 doctors that have given me 2 different ideas of how to reach my ideal breast size based on the picture provided. I am trying to stay with a modestly large natural look but I don't want to be top heavy. 1 Dr said 375-450 high profile silicone implants, and the other said 375-400 round moderate plus profile silicone implants... Any other opinions or suggestions? Thanks!

George Volpe, MD · Answer

The differences between implants that are the same volume of different profiles is often not as large as we think. For sure there is a difference and it can be several millimeters. A high profile implant will tend to be slightly narrower on the base of the breast but project slightly more. A moderate plus implant will give more fullness on the over breast relative to the high profile. At times, it is difficult to determine significant differences.

Sheila S. Nazarian, MD · Answer

Choosing the right size and shape of implant depends on any number of factors all of which require an in person exam. My best suggestion would be to seek a third opinion and then see which shape comes out the winner. Best, Dr. Nazarian

Steven L. Ringler, MD, FACS · Answer

Thank you for the question and pictures. I never use high profile implants because I think the moderate plus gives a much more natural result with fewer long term problems. I would agree with the surgeon who recommended the moderate plus implants, but I think the size may be a bit large fore your frame. Be sure to show the picture to your surgeon if you have not done this yet. Good luck.

Jerome Edelstein, MD · Answer

Thank you for your question, however dimensional implant sizing is based on precise measurements of your breasts and assessment of your anatomy. The implants which properly fit your base width, (for a proportionate look) will range a little in volume and projection. The sizes you've listed are very similar. Higher projection implants can provide more fullness, a fuller upper pole, and rounder look. I recommend that you ask to try on the sizers in office. My patients find it helpful to see how the shapes and sizes of implants will look in their clothing.All the best

Jaime S. Schwartz, MD, FACS · Answer

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. 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

Gerald Minniti, MD, FACS · Answer

Hello,Your goal picture model may have either high profile or moderate plus profile implants.  Her look (and everyone else who gets breast augmentation) is less about what profile they chose, and more about the relative size of the implants to her natural breast tissue. This is especially true with non-form stable implants which rely on the soft tissue envelope and gravity to shape the device.  Holding a moderate plus and high profile implant in each hand on their sides and you'll see they look pretty much the same in shape.  Keep in mind that this 'demonstration' represents no soft tissue support, only gravity collapsing the implants on themselves. In your breast tissue, a high profile implant can look more projecting inside the breast when seen on an MRI. This difference may or may not be visible externally, once again depending on the position of the implant in your breast and the amount of breast tissue you have. An examination would be required for better accuracy, but the planned implant sizes (either MPP or HP)  are likely not going to look like your goal picture, but instead look more augmented with a fuller upper pole, with the 375 having the greatest potential for looking like your goal.Best of luck!

Curtis Wong, MD · Answer

it can be very confusing and frustrating for the patient to determine what is best.  Find out what the dimensions are of those recommended implants and simply transpose the circle to your chest and 'see' which will make your breasts come ever so slightly closer together like your desired outcome photo shows.  And you should feel free to return to your surgeon's offices and rediscuss your goals.  If they are not patient with you and wanting to show you want you can achieve, I think its a good sign they will not be there for you after surgery as well and you should consider getting a third surgeon.  Patients should be the most important part of a surgical practice.

Michael F. Bohley, MD · Answer

Thanks for your question and photos. Your 'wish' photo shows a nice full shape without obvious excessupper breast fullness. Judging from your pre-op photo, you should be able to attain something very closeto this look. A high-profile implant is designed to give more upper pole fullness, and will be more narrow/less tall size-for-size than a moderate plus style. Your chest width will be a major determining factor in which particular size will fit the best. It sounds as though both of your consulting surgeons have settled on a similar size range taking multiple factors into account. It is never a bad idea to get a third opinion from a qualified plastic surgeon in your area if you have reservations. Best of luck.

Benjamin Chu, MD, FACS · Answer

If it is just that breast in the photo you wish for then the best way to try to match it is to use the Vectra 3D imaging machine.  With the imaging machine you can simulate either Moderate plus or High profile and see which image you prefer.  I think with your photos the MP+ will match the look you want.  First you must measure your base diameter to match the cleavage you want then select the volume which will fill the breast to the size you wish to be.  Best to select a doctor who at least has the Vectra machine.  Also try the Mentor implant sizing system to be sure of the volume you select is right for you.

Tom J. Pousti, MD · Answer

Thank you for the question.The difference between these implants 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. I hope this, and the attached link, helps.

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