Choosing Implant Profile

[veronika]

Thought this would be useful to some ladies:

Choosing the Right Profile: High, Low, or Moderate?
By: Richard D. Baxter, M.D.

Once the decision for breast augmentation has been made, the choice of which type of implant to use is one of the next important steps. The wide array of options can seem confusing at first, but in consultation with an experienced plastic surgeon, they can be narrowed down. Round implants now come in a choice of three profile shapes: high, moderate, and low. There are specific reasons for use of each type.

Ultimately, the process of selection is defined by:
1. desired size
2. the patient’s pre-existing anatomy
3. the desired shape and look.

The choice of size should be made on the basis of the patient’s desires in addition to the limitations of their anatomy. Most patients I see declare that they want a “natural” look, but that is largely subjective; in other words, the surgeon’s assessment may differ from the patient’s view, and others will have still a different opinion. We use the “cup size” method in order to discuss breast size, but everyone knows how unreliable this is. That is because the cup size system, introduced by the Warner Brothers Corset Company in the 1930’s relies on indirect measurements to infer the volume of the breast. It varies widely based as much upon the size of the person as on the breast.

Our practice is to have the patient choose the implant size by using a bra of the desired cup, then placing various sized sample implants into it. The patient has the final say over the size. The implant profile isn’t important at this stage, since the implants take on the shape of the bra, rather than the profile they will have after implantation. This step is for volume determination only. It is useful to remember, though, that implants typically appear up to 20% smaller after they are implanted. This may be because the look is different with the implant “stacked on” externally, as opposed to integrated with the breast into one unified shape. It is helpful for the patient to have more than one opportunity to try the implants on, so they will be more comfortable with the choice.

Pre-existing anatomy must also be taken into account when deciding which type of implant to use. For example, if the patient has a wide chest but desires close cleavage, the implants need to be large enough in diameter to avoid having an unnaturally wide space between the breasts. A woman with a narrow chest will require implants of a smaller diameter. If a breast lift is indicated, then still another variable is introduced. Different types of lifts affect the shape of the breast in different ways, and the implant profile can often help to counteract some of the limitations of certain types of lifts and improve the shape.

Breast shape is affected by several factors. The convention is to consider the breast as a static object only in the upright position, but in reality a natural breast changes with position and moves with activity. A perfect profile upright may look less ideal lying down or leaning over. Since round implants generally “behave” according to these criteria, they are the most popular type used. Once the round type is selected, the decision of which profile is best must be made.

The most important criterion for profile selection is the base diameter of the breast. This is easily measured by the surgeon with a calipers or measuring tape. The implant diameter must be less than the breast base, or it will be “squeezed” circumferentially. This will force it to scallop, or ripple around the outer edge, creating a range of other problems. Among these is visible rippling; I have observed much less rippling since the high profile implants became available, because the base diameter can be matched more precisely.

At this point, then, the implant volume has been selected and the maximum base diameter is known. One simply needs to refer to a chart to find the best match. In general, the high-profile implants are best when the volume needs to be relatively high on a narrower base diameter. In my practice, about one third of the patients fit into this category. Most patients match into the moderate profile group, and low-profile implants are used infrequently. They are most useful when base diameter needs to be enhanced without adding a lot of volume. A patient with a relatively broad chest and who wishes to enhance cleavage without being too large would be the typical candidate for low-profile implants.

High-profile implants are often an excellent option for patients who are having a periareolar breast lift (sometimes called a Benelli lift). This is because that technique, while minimizing the scar by placing it only around the outer edge of the areola, also tends to flatten the breast a little bit. The high profile implants counter this by increasing the central projection.

My view is that results from implant surgery can be improved by customizing the choice of implant profile to the patient’s anatomy and their desired size. This choice is best made in consultation with the surgeon. Pictures from websites can be helpful in communicating the look that the patient wants, but aren’t really useful in determining implant size or profile.

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Article Courtesy of Richard A. Baxter, M.D. - Seattle, Washington


"Because there are things women need to know about breast implants and augmentation"

[Bigger Plz]

Thank you sooooo much for this. I have been going back and forth in my mind as to which profile to choose! This clears things up for me!

[March26]

oooo awesome! will need to do more research but thats a great start for me!

[biggies]

Great lil article...bumping this up for other's
that might need some help on profiles...

[angiixchu]

Really great article !

Thanks

[tititita]

hi thank you veronika for this article,
i dont even know wichkind implant i have hi p,mp,lp,i know i have 250cc on the left and 265 cc on the right and i got a breast lift of te left breast,but i dont remember having the ps told me wich profile,i remember himpushing for silicone,wich i say no and decide to go for saline,well they look very nice ,so i guess he pick up the right ones,
take care,tititita.

[beckybee]

Great article. I wish this would be a sticky thread to avoid those threads that have an undercurrent of unhealthy competition and animosity surrounding implant profile. Some threads seem like "the battle between mods and HPs" with members on opposing teams rooting for their profile. Can't we all just get along? Sorry, I'm just being silly.

[JJ1979]

Thank you, Thank you, Thank you!!

I'm in the midst of the struggle to choose too! Waiting on the call back from my doc to get his feedback too.

I "think" I like the hps, but I do have a wider chest and would def. like some cleavage..ugh, why does this have to be SO hard? LOL