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

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!

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

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!