Under the muscle, silicone. What profile should I be getting for my breast augmentation? (Photos)

There are many ways to go about choosing implants, but my method is to first determine how much volume the patient is trying to add. After this, I determine the base width of the patients' breast. Once you determine the base width and the implant volume, the profile will largely determine itself. This is because the volume of a round implant is a function of the width of the implant and its projection, or profile.

This is such a great question, and one I hear often from women after pregnancy and breastfeeding.
Because you’ve lost some volume and have stretched skin, the choice between moderate plus and high profile really comes down to how much fullness you’d like at the top of your breasts. Moderate plus implants give a wider, softer, and more natural curve. High profile implants project a bit more forward, creating that rounder, perkier look that restores the upper-pole volume lost after breastfeeding.
At your size, 32 band, current small B, implants in the 350–375cc range will look beautifully proportionate. The 25cc difference is very subtle, it’s really the profile that shapes your result. If your goal is more cleavage and minimal spacing between the breasts, high-profile implants under the muscle are often the best match.
The most important part is finding an implant that fits your chest width and keeps your nipples pointing naturally forward. During your fitting, try both profiles with a sizing bra or 3D simulation, seeing the difference on your own frame makes the decision much easier.
You’re absolutely on the right track, with your proportions and goals, you can achieve a full, lifted, and natural look that feels like you, just refreshed.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon & Destination Doctor

I typically recommend subfascial implant placement for patients with a wider gap between the breasts who want optimal cleavage, because it allows the implants to get closer together than under the muscle, and the implants stay closer together with time since the muscle isn't pushing them apart. The addition of fat transfer can also be helpful for getting your breasts closer together. The difference between 350 and 375 is fairly small, but the best shape and profile for you will depend on your breast measurements and the type of implants being chosen.

Thank you for your inquiry! We, here at Mays Plastic Surgery, would like to sit down with you to discuss your concerns. There are different profiles to choose from depending on the final look you are expecting. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Dear alexandra2294,

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

Choosing the right size and profile breast implants for you. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, if interested. 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 size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

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."
With regards to your specific question, your choices sound reasonable. I would not struggle over small variation in volume as this is unlikely to make or break a result (45 ml is equivalent to a shot glass). I typically find that smaller framed petite patients opt for HP devices as this delivers the greatest volume given the restrictions of a narrow base width.
Communication is key as you and your surgeon create your custom surgical plan.
As always, discuss your concerns with a board certified plastic surgeon.

Thank you for posting your question here! my answer should not be considered as medical advice since i didn't get to examine you nor am i privy to your medical history.
Choosing a breast implant is a complex process , and you have to look at it in a 3D configuration , for an example for the same volume ( amount of ccs) a higher profile will give you more projection but will be narrower thus will have a smaller base thus less upper pole filling.
The main way to determine the best volume for you is using the breast width and matching that with an appropriate implant . you can always consider using the external sizers to get a better idea or if your surgeon has a 3 D imaging device such as the vectra device they can use that to give you a better idea.In any case I would encourage you not to goo too big just to avoid a lift as that will increase your chances of a possible complication in the future. If you need a lift then go for a lift. I hope this helps, best of luck!

The implants you are considering should give you a nice result. The difference of 25cc is less than two tablespoons of volume which is virtually undetectable in clothing. The higher profile is rounder and should give you a little more upper pole fullness, but either should do the trick. Many surgeons have sample implants available that you can "try on" to get an idea of how you may look after surgery. I've included a video on implant selection that I hope you find helpful.