Why are lower profile implants used so rarely? Is it truly patient preference or is it that surgeons prefer not to use them?

Question

I have sought a modest augmentation twice, and ended up with implants that were too projecting for my frame. 1st time 350cc saline (? profile), second time 275cc moderate profile saline. All I wanted was about the volume of one of the cutlets I wore in my 34B bra to fill it out. I am now replacing my saline implants with silicone and I know I want a lower profile implant. Why are these almost never used? I know it is a less common preference, but aren't there women like me who want subtle?

Anita Patel, MD, FACS · Answer

Great question! The moderate profile implants have the lowest projection and most women and surgeons find them a little too "pancake" like, or flat. Moderate Plus is more popular, and is a little more projected, though not as much as High or Ultra High profile implants. Subtle and natural looking can be achieved with the right implant, and the right choice for each patient is different. Changing from saline to silicone is a good start in terms of a more natural appearance, and placement under the muscle is also helpful. A profile change may or may not be necessary. There isn't enough information here to answer that, but make sure you see a board certified plastic surgeon for this type of procedure. Implant choice is not guess work to an experienced surgeon.

Richard Baxter, MD · Answer

The choice of implant profile is determined first by the patient's anatomy, specifically the base diameter of the breast. The desired volume then determines the profile. For any given breast width, the smallest implant would be low profile and on up. I mostly only use low profile when a breast lift is being done, as the breast adds the projection and the implant gives upper pole fullness without too much volume.

Shahin Fazilat, MD, FACS · Answer

Not every patient is a candidate for low profile implants- I always recommend speaking to your PS and showing images of your expected results.

Shlomo Widder, MD · Answer

Dear Washnigtonian,    Front and side views of your before and after pictures would have been very helpful. Sorry for the multiple procedures that you have to go through in order to achieve your desired size.      I have been in practice for over 30 years and performed breasts augmentation surgery on thousands of patients, many of them were Asian with a desire for a B cup size breasts. Based on that experience,  I can tell you that the profile of the implant is meaningless. Volume of the implants should be the only consideration for cup size and the pocket should be large enough to create soft and natural looking breasts.   You did not provide your original breasts cup size. Let's assume that you were 34 small A cup size, to become 34 B cup size, you would have needed implants with volume of 200 cc or 225 cc. If you were 34 A cup size, 150 cc implants would have brought you to 34 B cup size.   Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery , to make sure that they are numerous, consistent and attractive with nice cleavage, perkt, symmetrical and natural looking.                       Best of luck,                                           Dr Widde4r

Arthur Dean Jabs, MD, PhD, FACS · Answer

The profile of an implant is chosen to fit the base diameter of the breast. The smaller implants usually require a wider base as a starting point. As the size of the implant increases so does the diameter until you reach a point that a different pfojection (smaller base diameter for that volume) is required. The typical woman can use Moderate up to about 300 cc then requires Mod Plus. High Profile implants typically are used from 400 up unless the woman is quite petite.  
Hope this helps
Dr. J

Christopher L. Hess, MD · Answer

Your question is a good one because so few surgeons discuss the different implant profiles with their patients.  I always demonstrate the difference between low, moderate, high and ultra high profile implants.  You are right in that low profile implants aren't used as much as moderate or high profile.  Typically I use them in women who need a breast augmentation and breast lift where the upper pole has become flat.  In these women they typically have plenty of breast tissue and don't need the projection from the implant.  They just need filling of the upper poles.  The wider diameter of the lower profile implants fills the upper poles without the projection.  But your surgeon needs to understand your concerns when helping you to choose the implants.

Connie Hiers, MD, FACS · Answer

Most surgeons and patients want implants with a little more height than just "pancakes." The low profile implants are also more wide, and do not always fit well. You may need less volume instead of a flatter profile. Please discuss all your concerns with your surgeon.

Steven Wallach, MD · Answer

The reason low profile implants are not that common is that they are wide and flat.  Most people want projection and are not very wide. The "shoe" has to fit the person.

Kevin Tehrani, MD, FACS · Answer

Thank you for your astute question. I prefer low profile implants in smaller sizes as it provides moderate volume projection with maximal cleavage for the size and a very natural look. Some implant manufacturers have better options for saline vs silicone and expertise in augmentation especially in an exchange is necessary.

Maida Parkins, MD · Answer

Yes!  There are plenty of women like you who want a subtle change.  I had a patient who requested exactly what you are requesting (replace her cutlets) and we placed a very small low profile implant.  She was super happy :) the Saline implants have more projection than the silicone implants with the same name in the Mentor line (moderate profile saline has the projection of a moderate plus silicone) so hopefully switching to silicone will help achieve your goal.  You may also need to decrease the size (less than 275) if you really only want your cutlets replaced (unless your cutlets are that big- take them in and show your surgeon and she/he will be able to tell you how big of an implant it would be equal to).  Best wishes!

Why are lower profile implants used so rarely? Is it truly patient preference or is it that surgeons prefer not to use them?

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