Follow-Up Question: 385cc or 415cc? What is full profile?

Question

Age: 26 Height:5’7 Weight 115 lbs Currently: 32A (I don’t even fill that) Frame: narrow/slim So I did a resizing yesterday and I’m wondering if I should do 385cc or 415cc (with full profile)? Originally it was 365cc but I felt that was a bit small. I went over with my patient coordinator to go from originally 365cc to 415cc with doctors approval I was super excited but now I’m also nervous wondering if that may be too big?? I also have very little breast tissue.

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 moderate and Mod (+), in reality, is very small (on the order of millimeters). Anecdotally, most feel that moderate profile devices are too flat. 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/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, full profile implant will be narrower size for size than it's moderate counterpart. It will also project more and be less subtle. However, I would not struggle over 30 cc as this will make a subtle difference at best.  
In my opinion, the key to a "natural" look is conservative sizing with an eye towards anatomy and frame. Smaller framed individuals by "nature" do not typically have very large breasts. The value of a higher profile device is allowing a smaller framed patient to achieve a greater volume without overstepping the bounds of the BWD.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Bradley A. Hubbard, MD · Answer

Thanks for your question. The implants that you are considering are very close in size. I would not worry about going too big. You surgeon will likely approve this increase in size without repeat consultation because the difference between implants is negligible.Profile is a way to describe the width vs projection of an implant. I would trust your PS decision to choose the correct profile for your frame. Best of luck!

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

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.   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.   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

Daniel Barrett, MD · Answer

Dear PrettyBrownn_16,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

Benjamin Chu, MD, FACS · Answer

You talk about 365, 385, and 415 ccs.  The difference between each implant is very small.  Remember for a 32 sized frame it takes about 150 cc to increase your breast one cup size.  So for example 300 cc will increase your breast two cup sizes and 450 cc will increase your breast 3 cup sizes.   If you are actually below a 32A then 450 ccs will make you between a C and a D cup.  Increasing your breast implant volume by 30 is 30cc/150cc that only 1/5 of a cup size bigger which is not really a significant cup size.  So you should try to think in how many cup sizes more you want to be instead of thinking in cc.  You are not programmed to think in terms of ccs.  The other useful tool is the Mentor sizing system.  You can put on a contoured breast sizer which looks like a real breast in 350, 400 or 450 cc and right away you will figure out which is best for you.  By using these tools my patients are always happy with their choices of size after surgery.

Tom J. Pousti, MD · Answer

There are certainly a variety of breast implants available these days; semantics (such as "full profile" can certainly be confusing.

My best advice: more communication.

It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.

One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

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 "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 helps. Best wishes for an outcome that you will be very pleased with.

Follow-Up Question: 385cc or 415cc? What is full profile?

Answers (7)

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