High Profile Implant vs. Moderate Profile Implant (350cc)
Many times during a breast augmentation consult a patient will say to me: “I want to look proportionate”. In other words, the patient wants to make sure that a particular implant size will look right on her. The right proportion is determined by several factors. A good proportion is not only determined by the size of the implant, but it has a lot to do with the relationship of breast implant shape to the shape of the woman’s torso. Thus, in addition to the size, another way to achieve proportion is by varying the type of projection.
Breast implants come in many shapes, but the vast majority of implants used in cosmetic surgery have a round base. Round implants, when viewed from the side, have a certain height. This is called ‘projection’, because when the base of the implant is placed on the chest wall, that height projects out.There are two ways to increase projection in an implant. The first way is to add more volume to the implant. For example, in a saline implant one can add some projection by injecting more saline into the implant. However, saline implants do have a fill limit. If one injects too much saline, the implant will feel hard. On the other hand, a silicon filled implant can not be adjusted because it has a fixed volume of silicon. You can not add saline to a regular silicon implant.
The other way to add projection is to make the base (diameter) of the implant smaller. Thus for any given volume, a smaller base has more projection. This is what ‘high profile’ implants do—they have a smaller diameter with a higher projection. Think of what happens when you pour the contents of a glass of water into a soup bowl. In the glass, the volume of water has a small base (the bottom of the glass), but is rather tall (projection). In the soup bowl, the volume of water has a wide base (the width of the bowl), but is shallow (very small projection).
Let’s take for example the 350cc implant in the picture above. The moderate profile implant has a wider base when viewed from the top. The high profile implant has a smaller base. When viewed from the side, the high profile implant is taller (more projection). The moderate profile implant will appear distributed over a larger area on the chest wall, but will project less. There will be a smoother transition between the upper chest wall and the volume of the implant. The high profile implant will have a more noticeable transition between chest wall and implant, and it will project more. Neither implant is “better”. What is critical is educating the patient about how each type of implant affects the “look” she is trying to get.
For example, take a woman with a narrow chest wall. If she thinks she looks too small on top compared to he hips, she may want to consider a moderate profile implant which is wider and will restore some balance with her lower body. If, on the other hand, she wants a large cup size, but not necessarily a wide appearance on her torso, she is better of with a high profile implant.A woman with a wide chest wall will be better off with a moderate profile implant, and if she wants more projection, go for a larger moderate profile implant. The danger of picking high profile implants with their narrower base is that they may look too obviously “artificial”. This is less of a danger if the patient already has sufficient breast tissue thickness to wrap around and disguise the implant.
These guidelines are not absolute, as some patients do like a very pronounced cleavage, in which a high profile implant is more likely to create the desired effect. On the other hand, if a patient just wants to “fill out” the volume lost as a result of age or pregnancies, I’m more likely to recommend moderate profile implants.
As a patient you should be aware that you have a lot of alternatives beyond “I want to be a C cup”. You can pick the type of implant that is most harmonious with your body type and creates the best overall proportion. I always discuss these implant choices with my patients prior to their breast augmentation procedure.
Ricardo L Rodriguez, MD
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15 Comments
January 29, 2010 at 6:46 pm
Jimmy:
In general it is possible to go for much bigger implants if the skin has already been stretched.
As for your particular case, I would have to see pictures before I could make a more reasoned judgement. Contact Kelly at kelly@cosmeticsurg.net if you want more info.
Thanks for contacting us!
January 26, 2010 at 10:32 am
hi , my breast implants are done been 1year and a half ,i used to b a small b and got 375 cc it takes me to b a full C cup am planning for a redo to go up 3 cup sizes so would it b possible to go this big ..thanks for your help:)
November 24, 2009 at 10:05 pm
Jaqui:
In general, an over the muscle implant is more likely to give the “posh spice” look. It doesn’t have the extra layer of muscle over the top half of the implant to soften the transition between implant and chest wall. Thus, it does not look natural.
Since a high profile implant, by definition, has a more abrupt transition between chest wall and implant, it is more likely to look like an implant. If natural is what you are looking for, a moderate profile under the muscle will disguise the implant most. A high profile implant over the muscle will be the most unnatural of your choices!
November 24, 2009 at 8:10 pm
Im 34b and nit sure whether to have 300/340. Im having overs but so don’t want the ‘posh spice’ look. I want to look as natural as possible. Not too sure whether high/moderate profile will do this. Im 5′6 10 and a half stone. Size 10/12 on top and 12 on bottom. Is it possible for you to advice me on this issue
October 2, 2009 at 10:25 am
It is possible, but not advisable.
There are plenty of stories of patients having complications and not being able to access their surgeons after. There is no quality control like there is here in the States.
As for the recovery period, you need to heal.
I wish you good luck, but I strongly advise you change your mind and have the surgery done here by a board certified surgeon.
September 29, 2009 at 12:04 am
Hi! I am having an augmentation procedure done in Brazil and would like to also travel round a little bit while I’m there post op. (Nothing strenuous of course). I was wondering if you could please advise if this is possible? I am setting aside a week for recovery but would then like to walk around outside and see some of the sights. Would you recommend this?
August 1, 2009 at 11:32 am
The issue of sizing and shape of breast implants is so dependent on a full evaluation of your body type and expectations, that it is best done in a face to face setting.
Having said that, as long as you have given it some thought, don’t get too caught up in the details. Most people are happy with their choice.
There was a study a few years ago comparing oval to round implants, as evaluated by surgeons and nurses. Bottom line, surgeons had a hard time telling between oval and round implants. And that is the surgeon who does this on a routine basis! After seeing that study I pretty much gave up on oval implants.
As to high versus medium profile, I think it matters more when jumping from a smaller medium profile to a larger high profile.
June 20, 2009 at 11:02 am
I have not seen your pictures, and this decision is best made with your surgeon.
Having said that, I can tell you that high profile implants tend to have more of a “defined” look. They are more noticeable. They project more. If that is what you mean by “fuller” and “firmer”, maybe high profile is the look you want.
June 19, 2009 at 4:01 pm
hi, im having a breast enlargement in 3wks, i am a 34c, 10st and size 10/12, pear shaped. i want to go to a 34dd/e but i want a fuller and firmer look. my ps has told me 350cc under the muscle should be ok but i need to decide high/medium profile, i find it all so confusing! i’ve looked at pics but still finding it very hard.
June 16, 2009 at 10:35 am
If your torso is small relative to your hips, a moderate profile implant may help balance out your figure.
You should try on implant sizers at your doctors office. Try out the moderate profile version on one breast and the high profile on the other breast to see the difference.
This decision really has to be made in front of a mirror, with the plastic surgeon helping you find what you like. It is not a simple decision because it takes into account chest size, whole body proportions, size of implant itself, etc.
Ironically the best guide is to think about it a lot, then going by “gut feeling” when you are in front of the mirror trying on the implants.
June 14, 2009 at 6:44 pm
my question is that I don’t know whether to get moderate or high profile implants. I am only 5′1″ and 105 pounds, however I am muscular, but kind of pear shaped. (my hips are wide) I want to be big, but not too big, so i am opting for a full C/small D. I have 3 children and breast fed so I have been a full C before. My only thing I need to figure out now is… what type of implant to get? I don’t want them hanging under my armpits or touching in the middle, yet I don’t want it to look like I have baseballs on my chest either!
May 17, 2009 at 8:45 pm
There is no difference in size, but rather a change in appearance. The muscle over the implant softens the transition between the upper chest an implant.
The overall volume is the same.
May 13, 2009 at 1:50 pm
How much of a difference in size does it change the implant look from going over the muscle to under the muscle
May 13, 2009 at 11:22 am
These specific types of questions are impossible to answer without seeing you in person. If your surgery is next Friday, demand to see your surgeon or his nurse before surgery to have these doubts cleared. You have to hold the implant sizers in your hands, stand in front of a mirror, etc. Don’t fret, most patients are happy, and very seldom do people regret their decision as long as they think about it carefully. Good luck!
May 13, 2009 at 10:58 am
I started off with a B cup and got 325cc moderate saline implants above the muscle which got me to a big C small D but now I am going to a different doctor and getting a remove replace. I do want to be a full D but I nervous to go too big. Im 5′7 125lbs and my doctor reccomended 500ccs high profile under the muscle. I dont know how big that will make me and if its too much. How much smaller does going under the muscle make the implant look? Should I go with 400cc and fill to 450 or stick with the 500cc….my Breast Aug is next friday.
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