Breast Implant Options - High, Low, Moderate Profile Implants for Implantation

High Profile - Low Profile and Moderate Profile Breast Implants

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

Our practice is to have the patient choose the breast implant size by using a bra of the desired cup, then placing various sized sample breast implants into it. The patient has the final say over the breast implant size. The implant profile isn't important at this stage, since the breast 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 breast implants typically appear up to 20% smaller after they are implanted.

Pre-existing anatomy must also be taken into account when deciding which type of breast 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 plastic surgeon. The breast implant diameter must be less than the breast base, or it will be "squeezed". This will force it to 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, the breast implant volume has been selected and the maximum base diameter is known. In general, the high-profile implants are best when the volume needs to be relatively high on a narrower base diameter. Most patients match into the moderate profile group, and low-profile implants are used infrequently. 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. 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.

In my view, the 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.