Thanks for asking, Louise, and thanks for being here.
Profile is the single most confusing part of breast augmentation for most people. It's also really, really important to get right for long term results.
Implant profile deals with how wide and how tall the implant is. As an implant gets larger, it can either get wider (lower profile) or get taller (higher profile) or a little of both (moderate profile). Regardless, if you choose an implant that is wider than your breast, or narrower than your breast, it's likely to look weird. It may not in the short term but as the breast softens in time, if the implant is significantly narrower or wider than the breast, it's noticeable.
So . . .choosing profile, to me, is the last thing we do. I would ask you to tell me your goals, we would use a 3-D imaging system (I prefer VECTRA) and then you would talk to people on our team with implants who can help you understand why a particular size may be well or poorly suited to your lifestyle. Only then do we talk about profile.
After losing a fair amount of weight, the implant discussion may revolve around making sure we choose an implant both large enough to recruit some of that skin from the side of the chest and wide enough to also create some cleavage. So a high profile implant isn't a common choice unless it's a really large implant. However, a 32 inch band means you are not a big person. If one of our goals is to avoid making you top heavy, we might talk about a lift to narrow the breast, make them more similar in volume and remove the loose skin along the side (I KNOW, I KNOW, no one likes when I bring up a lift) so that we can choose an implant that is better suited to your small frame. But that's the kind of thing that comes with a consult. I would have to understand you, your goals, your expectations and the things you distinctly don't want to best serve you.
I hope this is helpful, please ask a follow up in you need more clarification.
Jeremy W. Pyle MD