Deciding between 345cc moderate and 385cc high profile

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing. Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan.
With regards to your specific question, relative to the moderate profile will project further and deliver greter upper pole fullness as a consequence of the greater volume (Remember 40 cc is essentially equivalent to a shot glass). Submuscular placement will to a certain extent flatten the roundness of the upper pole.
As always, discuss your concerns with a board certified plastic surgeon.

Thanks for your question!
I suggest going in and trying on the implants again. Bring a tight fitting shirt so you can get an idea of how they will look. In my experience, patients usually wish they had gone bigger. Best wishes!

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dear ailujdracis,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your question. Without an examination in person or at the very least photos it is impossible to make any specific treatment recommendations. That said, the higher profile is more likely to give you more upper pole fullness and roundness and less of a natural look. A Moderate Plus profile can also possibly work and it does not make sense that your optimal implant is either Moderate or High. For your frame and dimensions I worry that the 385 HP will look artificial or “augmented”. I personally also prefer a subfascial (above the muscle) approach for a more natural and anatomic placement, with less pain and faster recovery, if your breasts would allow for such.

Continue to do your research, discuss your options with your plastic surgeon, and when in doubt, consider a second opinion with an experienced board certified plastic surgeon whose aesthetics seem to align with your own, based on his or her Before and After gallery. Best of luck to you.

Going under the muscle does give nice upper breast fullness which most women prefer and are needing. As the size of the implant increases, the height may need to go up and the base down to fit. Your surgeon can help you with this. The additional 40 cc's is not a big change, so consider going with the larger implant if you thought the smaller was too small.

Higher profile implants will produce more upper pole fullness than a moderate profile implant. If you are wanting a more natural look the moderate profile under the muscle is more in line with your goals. I encourage you to return to your surgeon to further discuss your desired results. I've included a video I hope you find helpful.