Why don't I see any low profile breast implants with high CCs? (Photo)

Question

I want to get a very natural looking augmentation but can not seem to find any before and after photos of women who have gotten low profile implants in the 400-500cc range. It has me wondering why? I have about 100ccs of breast tissue and was told to go no larger than 490ccs based on my chest width. Because I can't find any before and after photos of low profile implants this big I am just worried I am missing something? Should I be worried about the outcome?

Gerald Minniti, MD, FACS · Answer

Hello,In general, low profile implants above 500cc tend to be rather wide, and most women don't have a broad enough chest for that wide a device. Appropriately sized pockets can be made, but they will be too narrow for the implants and they will sit inside the pocket folded on themselves, looking more like a high profile implants.More importantly, I'm concerned that a doc told you it was ok to put in 490 cc implant.  Regardless of it's profile, you do not have a breast that can accommodate that large of a device, and you will surely have complications (high riding implant, rippling, and/or double bubble).  Your skin is tight, your base width is not very, the distance from your nipple to inframammary fold is short, and you have little subcutaneous fat. You should go on a few more consults with surgeons who adhere to bio-dimensional analysis to determine optimum implant size.Best of luck!

Luke J. Curtsinger, MD · Answer

From your photos, you appear to be petite and slender. For an implant to look natural,  and not overwhelm your chest wall, you will need to match the base width of your implant to the base width of your chest. A 500 mL low-profile implant is very wide and is very unlikely that it would fit your chest wall. Implants that are too wide will bump in the middle (synmastia) and extend into the armpits.Petite, slender women who desire to have 400 to 500 mL implants, generally need to go to a very narrow base with implant, in other words, a higher profile implant. Consult with your plastic surgeon and express your concerns,  so that a volume solution can be tailored to help you get the proper width and volume that you desire.

Ronald J. Edelson, MD · Answer

Low profile implants used to be more popular.  They were mushy in feeling and surgeons hoped they wouldn't get hard.  But they did.  Moderate plus or high profile implants seem to be more popular the days because they tend to give a nice shape and better fullness.  Not many surgeons use low profile because they tend to be too flat.

Nelson Castillo, MD · Answer

Thank you for your photograph and for sharing your questions.  Breast implant selection is a difficult and confusing process because of the sheer number of available choices.  As a general rule, for the same cc size implants, the lower the profile, the wider the implant.  As you are petite, and appear to have a narrow chest width, a low profile implant would be inappropriate to get you the desired goal photographs of your complete profile.  The width of the implant would be too large to get you a similar breast volume.  In order to get a look closer to your goals, I would recommend you look at moderate plus implants and try on a variety of sizes at your surgeon's office so that you can see a better physical representation of the size.  Best wishes on your augmentation journey.

William Andrade, MD · Answer

Thank you for your question.  I find that few of my patients want low profile implants, because the diameter of even a fairly small implant is often too wide for the person's breast width.  Moderate profile or full profile implants are most frequently chosen.  However, I have occasionally used low profile implants for clients who are seeking cleavage but less projection.

Jeffrey D. Wagner, MD · Answer

Sizing implants is complex and definitely best done by a plastic surgeon experienced in breast augmentation.  A 500cc low profile implant is probably too wide for most women and you will probably have a hard time finding pictures.  Furthermore, pictures of other patients are often very misleading with respect to the result you can expect to achieve.  My best advice is to consult with one or more experienced plastic surgeon(s) in person for a qualified opinion tailored to you.

Sheila S. Nazarian, MD · Answer

Choosing the right size, shape and type of implant depends on any number of factors all of which require an in person exam. If you haven't already done so, schedule a consultation with a board certified plastic surgeon in your area (link below) to discuss the ideal option for you. Best, Dr. Nazarian

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. You should
choose a board certified plastic surgeon that you trust to help guide you in
this decision.

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

Curtis Wong, MD · Answer

and let your surgeon choose the profile/style that will allow you to best achieve your goals.  There are wide implants with large volumes but they are usually used on larger chested (broad chests) women.

Stacey Folk, MD · Answer

Dear Ceneri,Based on your photos, you look like a great candidate for a breast augmentation. The volume you prefer, as well as the implant profile, position, shape, and fill will all come into play with regards to how your breasts look and feel after surgery. There is a tremendous amount of variability when it comes to what "natural' or the "ideal" breast shape and size means to each individual person. Surgeons don't always share the same vision, so verbal and visual forms of communication are important when planning.Everyone would agree that silicone certainly feels more like a real breast than does a saline implant, so that is an easy one. Does increasing your breast volume by a factor of 5 still fall into the natural range for your body shape? You can tell by using a sizer and a full length mirror. If you are taller, this absolutely could be the case. If you have a tiny frame, your breasts may appear a bit more "store bought" at this size in your clothes.There is no formula here, it is just how it looks. Sometimes what looks great in your clothes, doesn't translate as well naked. This is where 3 dimensional imaging really helps patients. Some people who don't want a really big jump in size are disappointed that their naked breasts don't look more augmented and are still "too natural" , while others may really like the look of a sizer in there clothes, but look very round and fake on the computer screen. The base width of your own breast is an important measurement when picking implants. If the implant you select is significantly wider or smaller than this measurement it likely won't be a home run. Your surgeon would hopefully provide guidance on the profile once you have decided on the volume you like. This is also where the 3D imaging is very helpful. I have found that most patients are surprised that they prefer a lower profile implant on computer imaging than they had expected. This is definitely true for smaller breast augmentations or those desiring more upper pole fullness. It also gives you the opportunity to look at simulations of anatomic implants. Each company has a slightly different feel (the anatomics are generally firmer and less mobile) but this might be an option if the volume you like can be translated into an implant that would sit well on your chest.Petite patients wanting to jump 490cc will likely not end up with a low profile implant. Likewise, a larger patient with a broader chest probably won't be getting a 490 cc high profile implant either. Only one company (Sientra) uses the term "Low Profile" but every company has their lower profile choices. I do use lower profile implants when needed, and frequently when downsizing patients at the time of a revision. Our practices are all very different, and many of my patients are going for a sporty or less obvious size jump or more natural appearance. You probably shouldn't walk in to your consult having chosen your profile first, because for me that is probably the last piece of the decision making process. You are the first patient I have met with the predetermined preference for a low profile choice. It is almost always a patient coming in asking high profile when it is not at all what they had expected and need to be educated about what is the best profile for their body and desired results. Most patients don't know enough about profiles to comment unless they have had multiple consults. Kind of drawn out here, but I hope that was helpful. Best of luck!

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