High profile 300cc vs. moderate plus 285cc: can the high profile still give me that ski-slope look?

Question

Choosing between Sientra’s moderate plus at 285cc and HP at 300cc, both 11.4cm width. Projection difference of 4cm (mod) and 4.6cm (HP). My one-year post-op goal: lower-pole fullness, as natural as possible upper-pole slope. I do NOT want a defined, round outline of an implant up top. I also don’t want to wish I went bigger if I opt for the 285cc feels like splitting hairs, which makes it harder to choose! My question is: can the high profile still give me that ski-slope look?

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well.. based in your pictures and in the case , you are a good candidate for breast augmentation , in you case its recommended get a consultation with a plastic surgeon to check how many cc do you need to get very well results.

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), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Austin Hayes, MD · Answer

It's hard to give advice on sizing without an in person visit. However, based on your statement, "as natural as possible upper-pole slope" points towards a moderate-plus profile implant. As you change the profile of the implant, the slope of the upper pole will change. This straightest and most natural slope comes from the lowest profile implants, while the highest and most augmented looking slope comes from the highest profile implants. When in doubt, reach back out to your plastic surgeon. They would be happy to have you come back to the office to find the implant that's just right for you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Donovan Rosas, MD · Answer

Profile terminology will vary from one manufacturer to the next. The terminology matters less than the correlate dimensional measures.
As one goes up in profile the footprint or BWD of the device will shrink and the projection will increase for a given volume. I have found that full profile Allergan implants correlate closely with high profile Mentor implants. These devices exhibit higher projection than similarly sized moderate (+)/moderate profile devices. Ultra high profile is simply the next step upwards in projection.
Patients are encouraged to stay within the boundaries defined by their BWD. This is the best way to avoid the dreaded "fake" look. I generally recommend that patients with smaller frames who are seeking more than a modest augmentation consider a higher profile device.The higher profile device will impart greater projection and thus a less subtle result but will allow for a more significant augmentation than a similarly sized Mod/Mod+. Thus, the ultimate question is one of volume. Is the volume you can achieve via a similarly sized Mod + profile implant adequate to reach your desired goals? If not, a HP will afford you more volume at the cost of subtlety.
The difference between higher and lower profiles for a given volume is projection and for a given width is volume (with the high profile implant being greater in both scenarios). The moderate plus is the most commonly used profile in my practice. It allows for the most reasonable volume in given BWD. In my practice, low profile implants are the least commonly used (widest and flattest). I will typically reserve high profile devices for smaller framed individuals or those seeking a less subtle more dramatic change (the opposite of natural). 
Smaller framed patients tend to prefer HP implants as their BWD can be restrictive with regards to volume. An HP implant will provide greater volume in the same BWD footprint. But remember "natural" while difficult to define often implies a good match between frame, volume and projection. If the goal is natural more conservative sizing/volumes are recommended.
In general, the difference between a high and Mod (+), in reality, is very small (on the order of millimeters).  In my practice, I generally classify profile based upon patient preference. A higher profile provides a more dramatic look (size for size) vs. a moderate + profile which is relatively more subtle and understated. That being said the vast majority of patients will select a moderate + profile device.
With regards to your specific question, I try to get patients to commit to a particular profile first. This will determine whether they are seeking a more dramatic (HP) or understated (Mod +) result. Once we have narrowed down to a particular profile, we can look at options within that profile that are compatible with a particular patient's breast width/anatomy. The volume differential you are considering is slight (3 teaspoons) and is likely to contribute less to to your final result than the chosen profile.
As always, discuss your concerns with a board certified plastic surgeon (ABPS)

Daniel Barrett, MD · Answer

Dear luley80,Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, 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 it is 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, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.Daniel Barrett, MD

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Curtis Wong, MD · Answer

and getting natural is always hoped for and its alway more likely with the lower profiled implant over the high profile implant.  You cannot worry about wishing you went larger when at the same time  you want a natural upper pole.  15 cc's is not much either to sweat about (3 tsp) so if you want more natural, the Mod+ is better but if you want the fullest you can be, then the HP profile would be better as it sounds like your surgeon won't exceed the base width of 11.4.  You can always get a second opinion to make sure that your cleavage will be where you want it to be as some surgeons will not exceed your own natural base (and leave you with a big wide space between the mounds) and those surgeons that will to some degree.

Ronald V. DeMars, MD (Retired) · Answer

You're making a mistake if you think you should be choosing an implant. You should be able to discuss goals with your surgeon and show several postop photos of women with the look you prefer. With that information your surgeon shoold be able to have 3-4 implants available and do intraoperative sizing to choose the implant that comes closest to your goals.

Richard P. Rand, MD, FACS (retired) · Answer

In properly selecting a breast implant, you need to be carefully guided and assisted by your surgeon. They need to listen to your goals, discuss them as to how realistic they are, and do specific measurements on your body to select the correct implant diameter. Without the correct diameter, no implant will look good, no matter what profile. The profile is the thing that finalizes the look and the size. In younger patients with firmer tighter tissues, long lasting upper pole fullness is what the higher profiles are designed specifically to make. In patients with less firmness, they will settle in over many months but will never "ski slope". In fact, NO implant can make a ski slope upper pole, they all fill in the emptiness up there and the lowest profiles give a straight line upper pole. Also, lower pole fullness or underhang can only be achieved in a patient with enough skin in the lower pole. You should review things with your doctor or seek other consultations.

High profile 300cc vs. moderate plus 285cc: can the high profile still give me that ski-slope look?

Answers (9)

More Breast Implants Questions

Almost 5 months post-BA and my scar opened up, what do I do? (Photos)

330cc modern (under muscle implants) Can someone explain why my left implant feels a bit hard and is a bit higher. (Photos)

11 days post-op and I feel weak and I’m very pale. Is this normal?

11 days post-op and my breast still feel hard and tight, could it be capsular contracture? (Photo)

Which size 350cc, 375cc or 400cc will make 34B, 5’5”, 140lbs to full C/small D but still look natural?

Breast augmentation booked with lateral (outward facing nipples). Will I get a good result? (Photo)

WE SEND PRETTY
EMAILS