HIgh Profile vs Moderate in first BA, what would you recommend?

For my first BA should I go with a UHP? My friend says to do it because over the years they'll stay youthful looking and not sag so much.

Doctor Answers 14

Ultra High Profile Implants?

I am curious, how many breast augmentations has your friend performed? Where do they get their special insight, because I wouldn't agree with their analysis? One should be careful about taking a friend's advice too seriously. They can unknowingly project their desires and notions on you, but they won't have to live with the consequences of the decisions. 

Ultra High Profile implants are typically too narrow and over projecting for most patients. They tend to get used in situations where patients want a lot of volume but have a narrower breast/chest, in an effort to avoid excessive lateral fullness. Often the result is over stretching of the tissues, easily palpable or visible implants, and increased risk of problems of malposition or bottoming out. While these changes wouldn't be considered "sagging" they aren't a positive outcome. 

Too often there is way too much emphasis placed on a specific profile to achieve a certain end. The differences in profiles for implants of the same volume is measured in millimeters, so in most cases it is difficult to see much difference. Implant profile is a secondary consideration after other metrics such as base width and volume (cc's). The profile is then chosen for the best fit to the breast shape and position. Implant profile alone will have no impact on the durability of the result.

Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 81 reviews

Implant projection

Choosing the projection is based on planning .  Surgeon must consider your existing breast shape and dimensions , as well as your desired result, to recommend an implant size and projection.

Steven S. Carp, MD
Akron Plastic Surgeon
4.6 out of 5 stars 32 reviews

Moderate or High Profile Breast Implants for Augmentation?

For a more natural look with a better cleavage I'd strongly recommend and do recommend to my patients either a moderate profile or moderate + profile implant.  I believe that it is when patients want extremely large volume implants that a high profile implant is considered by some so that the base width does not exceed the natural breast diameter on the chest wall.  I always recommend avoidance of overly large breast implants since with time their weaknesses become apparent to patients' regrets.  Breast tissue thinning and skin stretching under the weight of large implants doesn't happen to all over time, but does to many.

I also prefer choosing the final implant during the surgical procedure when actual test breast implants can be inserted and judged for size, shape and contour.  Enjoy the video link above.

Best wishes,

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast Implants

Unless your friend is a plastic surgeon with many years of experience, I think you should look elsewhere for your answers. The advice you have is certainly not correct. No implants sag but breast tissue does no matter what the implant might be.  UHP implants look extremely artificial, so if that's your goal then go with them. But the majority of implants used in this country are of the moderate profile because they have such a natural look. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Your friend is wrong.

 Your first breast implant will set the tone for your future with breast augmentation. If you go too big or too projecting with your first surgery, then there will be a lot of release of the chest muscle and may set you up for a lot of problems down the road. Also, the bigger the implant, the more it will sag and the more repair that will have to be done in the future. If you have a lot of breast tissue, there is nothing that an implant will do to keep your breast from sagging. Unless your friend is a plastic surgeon, I would take the advice of an actual plastic surgeon. Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Which Profile of Breast Implant what would you recommend?

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. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

High vs. Moderate Profile

High vs. moderate profile implants simply indicates the width vs. projection ration.  High implants are selected for those that want more projection but less width while moderate is just the opposite.  The most common profile is the moderate plus implant which combines the best of both.

Gregory DeLange, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 56 reviews

Rely on your plastic surgeon’s expertise.

Plastic surgeons base their recommendations for breast implant size on many factors, including their years of training in both technique and aesthetics. A plastic surgeon also needs to evaluate your existing breast tissue, take measurements of your chest and the base of your breasts and talk with you about your goals for breast augmentation. After an examination, a plastic surgeon can give you a personalized recommendation about what size and profile of breast implant may be right for you. Ultra high profile, high profile and moderate breast implants can create very different looks.


Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 120 reviews

Don't Listen to Friends


UHP implants are at the greatest risk of malposition, loss of upper pole fullness, pressure induced atrophy of your own natural breast tissue, and development of the 'rock in sock' appearance to your breasts. If you are looking for longevity of a great result, start thinking more about placing the right size and type implant for your body anatomy, not some ill-conceived aesthetic goal (e.g. cup size).  Go visit a few ABPS certified/ASAPS member surgeons that perform all types of cosmetic breast surgery. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.