Profile of implants
i choose a specific profile based upon a patient's anatomy. In general, on a very narrow person who wants a large implant, will more than likely go with a moderate plus or high profile silicone implant.
What profile of implants
How to Pick
the Right Size and Shape of Breast Implants
of the more frequent questions I'm asked as an aesthetic plastic surgeon for
patients considering breast implants is "how do I know what size, and shape I need?” The answer to this
question has changed dramatically throughout the 25 years that I've been doing
breast augmentation. I've also learned that the words that patients used to
describe either what they want or don't want can be completely misleading into what
I interpret their meaning to be. Therefore, I like to request that our patients
considering breast augmentation bring in photos of both what they think they
like and what they don't like. There seems to be a multitude of sources on the
Internet where these photos can be downloaded. By looking at the patient's
desires, I get a better understanding of what they want. We no longer recommend
that we place the exact implant on top of the existing breasts and then place a
stretchy bra over it to give us any idea what that exact same implant under the
muscle would produce in size. That method, in my opinion, will always over
represent what the actual result will be. If you are going to use a sizing type
method, then Mentor makes a shell sizing system such that, when the shell size
corresponding to the implant that it represents is placed over the existing
breast and in a bra, it will better represent what that size implant under the
breast and muscle will look like. We've also used 3-D imaging called Vectra® since
its inception some 6 to 7 years ago. With this method, a three-dimensional
photograph of the actual patient is taken and can be seen on a large screen
television by both the physician and perspective breast augmentation patient at
the same time. We then can place all of the different implants that are
available under that image and decide what size, shape, fill ratio, and height
to base width relationships will look best for each patient. Silicone gel
breast implants come basically into shapes either round or shaped. They also
come with either a textured or smooth surface. In my mind, there are advantages
and disadvantages of every scenario and combination of those choices. Most of
the time a round smooth implant placed under the muscle works very well for
breast augmentation patients. It's then very simple to just look at size and
ratio projection to base width and select the perfect implant for that patients
shape and desire. Sometimes we would like to use a textured surface implant.
Here the advantages are that the textured surface implants tend to migrate less
in the pocket, as there is some frictional resistance to motion. Another
advantage of textured implants is that the capsular contracture rate,
especially when implants put above the muscle, is less than for smooth wall
implants. Shaped implants, because we do not want them to turn in the pocket,
are always textured. My planning method to optimize the best implant for each
patient is begun with a measurement of the base width of the breast. We would then
like to subtract about a centimeter and a half total off of that number so as
to have coverage of breast tissue over the implant. We then will have a range
of implants whose base width matches that number. If we go larger than that
number, which sometimes patients will want, we as plastic surgeons know that
these larger implants can have more problems down the line. For instance,
larger implants may migrate below the crease which one has to lower at the time
of surgery in order to get the implant in. When these implants migrate below
the natural crease, they can create a second crease in what we call a
"double bubble". Large implants can also; because of the pressure
they put on the overlying breast tissue, thin that tissue out such that there
is less overlying breast tissue over the implant as time passes. After we have
the base width, our next decision needs to be what is the ratio of the base width
to the projection of the implant. Essentially, there are usually four choices
ranging from fairly flat which is called low-profile, to progressively more
height and less width with the same volume of silicone gel, which is called
ultrahigh profile. There are two profiles in between which are the ones more
commonly used and these are called moderate profile and moderate profile plus.
Common scenarios in which taller implants would be desired may be in patients
who want a larger look than their natural base with would allow or have a fair
amount of loose overlying skin that were trying to hold up. For patients who
want a more natural look, a moderate profile or moderate profile plus shape is
more desirable. There are also anatomically shaped implants. Rather than being
around these implants can either be taller than they are wide or wider than
they are tall. There are good reasons in patients to use either. For instance,
in the patient's with very widely spaced breasts and a large breastbone, a
shaped implant that's wider than it is tall can help hide that a little bit.
Another example of the patient in who a shaped implant would be best, is that
patient with laxity after childbirth or weight loss. When the nipple is just at
the level of the inframammary crease, we can sometimes get away with a tall
implant that is anatomically shaped such that the nipple when is it at the
lower two thirds of the breast mound created by the implant still looks good
and natural and may obviate the need for a breast lift. By spending some time,
long before the operation takes place, using the Vectra® 3-D imaging method, we
can decide what type, shape, and ratio of width to height would best serve the
patient's needs. We can then avoid what is sometimes done which is the
placement of sizers at the time of surgery. These sizers, in my opinion, have a
few negative implications. One is that there is a cost inherent in using them
and usually multiple ones are needed to make a decision as to which implant
would look best. I also believe that placing sizers in and out of the breast
pocket can be traumatic to that pocket and can cause bleeding. For me, the
state-of-the-art in today's breast augmentation is to decide long before the
operation exactly which implant would look best using computer animation. A new
wrinkle into the choice of breast implants is that breast implants now come
with silicone gel that is filled to a higher volume in the shell where it is
placed. This will allow for a round smooth implant, for instance to collapse
less in the upright position mimicking more of the look of the shaped implant.
When patients show me a photo of a very rounded upper part her breast, I would
likely choose one of these higher volumes implants such as the Natrelle
Inspira® silicone gel breast implant. Often times patients will present with
breasts that are of different sizes. One of the options to correct this is to
use breast implants of different sizes in order to best create symmetry. One of
the newer methods to help in symmetry creation is to do what we call a hybrid
breast augmentation. In the hybrid breast augmentation, the patient who has
asymmetry of the breast to begin can have matching silicone gel implants placed
and the overlying breast tissue can be made to look the same in volume and
shape by using fat grafting. In that way, no matter what the change in weight
of the patient is over time, the breast is more likely to have the same or
similar size. When it comes to symmetry, I like to tell our patients that they
should consider their breasts to be sisters that live across the railroad
tracks from each other rather than twins. With proper preoperative planning and
flawless execution of breast augmentation, this can be one of the most
satisfying aesthetic plastic surgery outcomes for both patients and physicians.
Breast Implants / Breast Augmentation/ Cohesive Gel Implants / Silicone Implants / Revision Breast Surgery
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!
Certified Plastic Surgeon
Hills Breast and Body Institute
Breast Implant Choices
Thanks for your question. Your decision regarding high vs. moderate profile is important as it will change the way you look in clothes, bra, bathing suit, and birthday suit - so important :). Bring in some pictures of your desired look to your upcoming appointment, discuss how you want to look in sweater vs. bathing suit, and see if your board certified doctor has 3D imaging.
Wishing all the best,
Steven Camp MD
High or moderate profile for my frame?
Choice of breast implant photo will depend on your examination by board certified plastic surgeon and your specific goals. To read more on the breast implant profile please read the following link:
Best breast implants for me?
Thank you for the question. There are several steps taken to select a specific size/profile breast implant for a specific patient. The difference between the different profiles of breast implants available have to do with the dimensions (diameter and height) of the implants. For example, the high-profile implant has a greater projection and a smaller diameter compared to the moderate profile implant. The moderate plus profile implant as projection and diameter characteristics that fall between the moderate profile and high profile implants.
I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
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 (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes.