I am currently a smaller B cup. I want an ultra high profile silicone implant and I am considering 400cc. (Photo)

Question

I am 34 yrs 5'9 130 lbs I am most interested in the ultra high profile silicon implant. However; I have met with two surgeons that have only shown me high profile. The third surgeon said the ultra hig profile would fit my frame and give me the full look that I have always wanted. I agree with him but other opinions are always very helpful. Thank you

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I think that for cosmetic augmentation, the ultra-high profile implant is rarely needed and can sometimes look overly fake and projected. The only time I use them is if a patient wants a very significant increase in volume and the width of the chest is so small that the volume they want requires that amount of projection. Bottom line, if you want a 400cc implant, then the implant with that volume that most closely matches (or is slightly below) your base width, will provide the most natural and pleasing results. In your case, I would be willing to bet that a moderate or high-profile implant in the 400cc range matches your chest better. Make sure you are consulting with a local surgeon who is board certified by the American Board of Plastic Surgery. Hope this helps!

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question!
  
After performing hundreds of breast augmentations, I have found that 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. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.
  
Silicone will give you 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 softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.
  
Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is 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. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.
  
We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.
  
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 
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Richard H. Fryer, MD · Answer

I probably use more ultra high implants than any surgeon in this area, and possibly even in the country.  My patients tend to be very thin, petite, athletic appearing women.  In these circumstances it is mistake in my opinion to use implants that make the chest look wider or broader; that is exactly what would happen with a lower profile implant of the same size.  The ultra high profile implants DO NOT make your breasts look like torpedos or look "ultra fake" like some doctors have stated on this forum.  The most important thing is taking careful measurements and using an implant that conforms to your measurements instead of making your breast conform to the measurements of the implant.Ultimately you need to FEEL comfortable with the surgeon and plan that you decide on.  Perform your due diligence by researching your plastic surgeon and checking out the reviews in order to help make that decision.If you would like more information about breast augmentation, you can download my free breast augmentation planner at aBetterBreast.comGood luck in your decision making process!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  It is difficult to offer definite advice without knowing some key breast parameters and what are your desired goal results but you appear to be narrow chested which may make an ultra high profile implant a possibility to best match the dimensions of your breasts especially if you are looking for a higher overall volume.

Urmen Desai, MD, MPH, FACS · Answer

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Keith Hodge, MD · Answer

If you are wanting a round and augmented appearance with more volume in the upper breast, then the ultra high profile is the way to go. As long as the 400cc implant isn't too wide for your breast dimensions, then it should look very attractive. Good luck!

Kirk Moore, MD · Answer

Without an in-person consultation it's very difficult to give you a definitive answer. There are many factors, namely breast width and tissue characteristics that are extremely important to making the right decisionMy gut feeling, based on your pictures, is that the ultra-high profile implant is far too narrow for your breast shape/size, and will not give you the look your are seeking. Not knowing those measurements/characteristics, though, puts us on here, at a distinct disadvantage. Best.

Daniel Barrett, MD · Answer

Dear kbrown007,Determining the idea breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. We have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements. Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If its too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match. Of all of my breast augmentation patients, everyone of them have been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result thats either too big or too small.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

Tom J. Pousti, MD · Answer

Although you will receive many (and differing) opinions online, none of the opinions will be relevant to you specifically, when it comes to your specific anatomy and personal goals. Ultimately, nothing will replace in-person evaluation including a careful physical examination and careful communication of goals when it comes to providing you with specific/relevant advice. Having said that, generally speaking, I have many very happy patients who have utilized  ultra high breast implants to achieve their desired outcomes. These patients have ranged from very petite to larger patients.   Generally speaking, the best online advice I can give to ladies who are considering 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 are 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. For example, I have found that the use of words such as “natural or fake look” or "C or D cup” 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. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery sizing concerns) helps. Best wishes for an outcome that you will be very pleased with.

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

You have very natural attractive looking breasts and I would be reluctant to do anything that might detract from the looks that you have.  The breast implant that you choose should have a base diameter that matches the base width of your breast.  To read more about how to achieve a natural looking breast augmentation please read below:

I am currently a smaller B cup. I want an ultra high profile silicone implant and I am considering 400cc. (Photo)

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