Breast augmentation: High profile implants create projection and fullness

Posted on | Modified on | by Dr. Ricardo L. Rodriguez
A photo of a high profile implant and moderate profile implant (350cc)
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; 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 you can add some projection by injecting more saline into the implant. However, saline implants do have a fill limit. If too much saline is injected, the implant will feel hard. On the other hand, a silicone filled implant cannot 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” than the other. 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 her 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. The high profile implant will also create more fullness in the upper pole of the breast. If the patient has sufficient breast tissue thickness to wrap around the implant, it reduces the chance that the higher profile will look too artificial.

A woman with a wide chest wall will be better off with a moderate profile implant, and if she wants more projection, she should go for a larger moderate profile implant.

These guidelines are not absolute, as some patients do like 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 in great detail with my patients prior to their breast augmentation surgery. And you should discuss all of your options with your board certified plastic surgeon, too.

By Dr. Ricardo L. Rodriguez MD Board Certified Plastic Surgeon Cosmeticsurg Baltimore, Maryland Ricardo L. Rodriguez on American Society of Plastic Surgeons.

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37 thoughts on “Breast augmentation: High profile implants create projection and fullness”

  • Sydney Caffey says:

    Hi I was just wondering how much a breast augmentation procedure would cost normally? I know it probably depends on a few different things, but I was just trying to get an idea.

  • Ann-marie Murphy says:

    Hi I am looking for the real round shaped implant and nice snd high more fake looking but I had an uplift done 10 years ago and now they have dropped I have no implant in but I was told I would have to uplift agsin for this any advice

    • Dr. Ricardo L Rodriguez says:

      Ann-Marie: I would have to see pictures to tell really what you need. Without having seen, and with very little to go on, I can guess you may benefit from an implant but I really need more info to make a real recommendation. Contat Kelly at kelly@cosmeticsurg.net and we can set you up for a virtual consult. Thanks!

  • Kendra says:

    Hello Dr. Rodriguez! I went for my consult and picked my dr, my surgey date is may 13.....:() Im very exited but so nerves on what size to pick and what profile... : / im 5"10 and 130lbs my hips are 35"inches. I dont want to look fake up top or to small. The Dr I picked said i could do 497cc mod or 550cc high. If i went with more cc on the moderate they would sag in a few years and i could have rippling or problems? Why would that not happen with the high? And do you maybe have any advice on what size i should go with? Or pictures of girls my size that went with high and mod? Hope to here from you soon! Thanks Kendra:)

    • Dr. Ricardo L Rodriguez says:

      Kendra: You have picked your surgeon and time of surgery. It would be inappropriate for me to offer an opinion as I have not seen you and your doctor has seen you and evaluated you. Don't worry though, most people are happy with their implants.

  • Sandra says:

    Due to breast cancer, I had both breast removed. My first implants were virtually the same size as what I had before and I did not feel there was enough projection. The two implants practically touch in the middle of my chest. I am planning to have them redone as they are different sizes, one is higher than the other, and there is a rippling affect on one breast. I am 5 2" tall and weight 125 lbs. I was not given a choice the first time and the surgeon chose medium profile implants. How much difference would high profile implants make? My plastic surgeon said that would not look real if I went high profile. I am also getting a tummy tuck and the plastic surgeon thought that would make a big difference in projection with out the high profile. Help?

    • Dr. Ricardo L Rodriguez says:

      Sandra: First of all, any advice I give here without having seen you is in no way comparable to what is being told to you by a surgeon who is seeing you and evaluating you. So take what I say solely as an opinion of how I approach situations in general, and it may not apply to your case. Since you are having a Tummy Tuck I would consider harvesting fat tissue and doing fat grafts to the breast skin envelope. This will soften the appearance around the implants and decrease the chance of rippling. That then gives you the added option of choosing a high profile implant that will look more natural. Good Luck!

  • bbygrl says:

    hello what type of silicone implants do you carry? gel? And do you carry mod+ or just mod and hp? Could HPs under the muscle with a small B cup starting point give a natural look?

    • Dr. Ricardo L Rodriguez says:

      Sorry we took so long to answer. Your condition is called breast ptosis, which is a fancy name for hanging breast. If your breast is the size you like, then you need a breast lift only. But if you want a high cleavage and fullness above the areola, then you need a lift. Hope this helps!

  • Tammy says:

    Hi, I am going in for bilateral augmentation mammoplasty with mastopexy in four n half weeks. I have to decide what type and size inplants to go with and its been a struggle. I kinda had my mind set on more of the high profile as apposed to the moderate profile. I am 5'6 about 126lbs and one breast is about an A cup and the other closer to a B cup. The doctor said he would make the bigger one a bit smaller to match the other breast and then put the same size implants in. Is this a better choice as apposed to two different size inplants? I would like to be a full C cup as well, so how many cc would you recommend to get this look? I want a unatural look with nice cleavage? Thank you Tammy

    • Dr. Ricardo L Rodriguez says:

      Tammy: It would be impossible to make those kind of judgements without looking at the breasts. I suggest you ask the surgeon to try sizers on at the prep visit so you can get a better idea. Keep in mind the sizers look a little bigger than what the implants are going to look like under the breast, so if you like a 300 sizer, you probably should get a 325cc implant. But really, only the surgeon who is looking at you can make those judgement.

  • alexi says:

    I am a 34B on the left breast and a 34AA on the left breast. I am narrow at the shoulders. I'm 5 ft 3inches, 120 pounds. I'm looking to have a natural look, yet have some cleavage. I have gone to some consultations and have decided to do silicone implants, 325cc on the left breast and 350cc on the right. However, I'm having a tough time deciding whether to pick high profile or moderate+. The consultation I went, told me my narrow shoulders allow me to do both and still pull of a natural look. However, this does not help with my decision. Before I decide to go high profile, I would really want to know if doing high profile under the breast muscle will give me a natural look. I do not want for everyone to notice instantly that they are implants. Please help.

    • Dr. Ricardo L Rodriguez says:

      Alexi: "A natural look" is a very subjective concept. Most of my patients start the consult saying they want a "natural look" at the beginning of the consult, yet after trying out both types of implants side by side, about 80% of the patients choose High Profile implants and are happy with them. Try on the same implant volume (say 300 or whatever size you fancy), a high profile on one side, and a moderate on the other side. You will just have to trust your own instinct as to what looks best to you. There is no "correct" answer to what you are asking, because "natural" means different things to different people. Trust your own perception.

  • kim says:

    i have 325cc moderate for a year but want to go bigger im a big c/small d cup wants to be a full d to small DD.im thinking i should get 475cc hight profile but dont know what i should do.will high profile 475 look alot bigger then what i have now 325cc morerate or should i go 450cc or 500cc to to be only a cup size more?

    • Dr. Ricardo L Rodriguez says:

      Kim: The best thing for you to do is to have a consultation where you actually see and feel the different implants, including one the size of the one you have now. As a general rule, I recommend going at least 100 cc's bigger if you want a noticeable difference. Going to a high profile design also helps. Hope this helps! If you want further info you might contact Kelly at kelly@cosmeticsurg.net, we'd love to help you

  • Meg Lion says:

    I just had 400cc high profile memory gel implants placed on Feb. 2, 2011. The implants are still high and firm, not much pain though. How long before the implants will "fall" into place?? thanks!

    • Dr. Ricardo L Rodriguez says:

      Meg: Without knowing what kind of placement your surgeon did, it is hard to predict how long it will take for your implants to drop. You should ask him, I'm sure he'd be happy to give you a good answer. Congratulations on your new figure!

  • Niki Parker says:

    I had a sailine(under muscle) breast aug. in 1998. I am 33 yrs old and my breast look natural 38d. I do NOT want natural looking breast...I want porno round...pls excuse the expression. I am a large framed woman and very broad. wt 185 hight 69 inches. Trying to figure out if wide profile, silicone, over the muscle ...maybe with an internal bra / sutures will give me this look. also want them to stand str8 up when I lay down and to almost touch standing up(cleavage). any advise ?

    • Dr. Ricardo L Rodriguez says:

      Niki: Your request is not as uncommon as you think. We are used to all sorts of requests, that is why we have all kinds of implants and have our patients touch them and feel them and compare them prior to make a decision. What you want is probably Inamed style 25 which is a very high profile. We'd be more than glad to help you reach your goal. Contact Kelly at kelly@cosmeticsurg.net

  • Stacey says:

    I am having a breast aggmentation done in two weeks and today at my pre-opp appt the Dr. told me he recommendes a high profile implant. I never thought about which profile to get. Now that my surgery day is fast apporaching, I need to figure if I should go with the high or stick to the moderate. I am 31, 5"5" and 140lbs, and shaped like an hours glass. I have broad shoulders and wide hips. I think I could handle a high profile implant, but I don't want to walk out looking like a porn star or have my breast walk into the room before I do. Without seeing me do you think I should stick with a moderate implant or go with the suggested high profile implant. Yikes what to do?? HELP!! THANKS!!

    • Dr. Ricardo L Rodriguez says:

      Stacy: There is no way I could responsibly give you advice sight unseen. In my office I have patients try on both types of implants (high profile and moderate profile) so they can get an idea of what they would look like. It's not a perfect system, but it helps to give the patient an idea. Ask to see your surgeon again to discuss this and try the different implants on. You are paying good money, you have a right to expect this. Above all, don't go into this not being sure of what you want. Good luck!

  • jimmy saab says:

    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:)

    • Dr. Ricardo L Rodriguez says:

      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!

  • jacqui says:

    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

    • Dr. Ricardo L Rodriguez says:

      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!

  • Stephanie says:

    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?

    • Dr. Ricardo L Rodriguez says:

      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.

  • jodie says:

    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.

    • Dr. Ricardo L Rodriguez says:

      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.

    • admin says:

      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.

  • colleen w says:

    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!

    • Dr. Ricardo L Rodriguez says:

      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.

  • Jaclyn says:

    How much of a difference in size does it change the implant look from going over the muscle to under the muscle

    • Dr. Ricardo L Rodriguez says:

      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.

  • Jaclyn says:

    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.

    • Dr. Ricardo L Rodriguez says:

      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!