Question: Implant profiles

Hi, I am looking for advice more from the medical perspective, regarding profiles. So I’m 5’5, between 113-145lb, 30yr old, 32inch under bra band. Looking to have implants due to dramatic weight loss. I was a full C small D cup when I was fatter. Since loosing my weight, from the areola up to my clavicle I have lost volume. The roundness at the bottom is lovely and you can grab a handful but there’s a big slope and I want it fuller. They are perfectly positioned....just a bit deflated. I have the ability to pull a good amount of tissue from the side of my armpits into a push up bra. So I wonder whether I need to go larger to fill out the tissue. I understand it’s quite hard to advise without seeing. If you have more tissue to fill out, what profiles work best. I get confused with what high/moderate/low would look like. (My right boob is a bit smaller than the left, the left isn’t at an odd angle, it’s just the photo, they’re usually perfectly placed, just hang quite low) Thanks for any advise

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

Thank you for responding. Everything you have said has been really helpful. Especially as in my mind, it sounded like a moderate to high profile would make more sense. Now you’ve explained a bit WHY that might not look so good it is a bit clearer in my minds eye. Yes, the dreaded mention of a lift ! So the reason I was really hoping to avoid this at all costs, was because you have to remove the nipples don’t you and place them in the new position? I personally don’t feel comfortable enough to go through with a lift if I get implants as I wanted to attempt breast feeding when I eventually have children. My research has led me to believe whilst perfectly possible to do with implants, I might have to be prepared that the flow won’t be as strong. I feel with already potentially giving myself issues with this later, a lift or anything involving surgery to my nipples is going to flat out ruin that chance and the list of potential complications surrounding this, outweighs the pros for me. As I am U.K. based, the hospitals I have looked at provide a 40 minute consultation where they use the vectra program you mentioned and will allow me to try sizers on also whilst doing all the measurements and checking the surrounding tissue. When I don’t have a bra on, thankfully the skin at the side holds its own ok, so it doesn’t actually look aesthetically toooo bad. This was another reason why I thought I could try and avoid a lift . Whether that principle applies surgically, I guess I shall have to find out. Goals wise, as I was always smaller chested (till I put the weight on) in a perfect world, I would love a bit more of a natural voluptuous look, as is in the pictures I’ve attached. Whether this is achievable, is another matter. At the end of the day I am happy to go for a size that is best suited to me and my lifestyle. I have been doing more weightlifting in my workouts and have found I would like to go a bit further with it. Not at a bodybuilder level, just to the extent of a good toned look. Unfortunately one of the side effects of this is I’ve started noticing that I can see a little bit more of my pec muscle up top, and then boob tissue below. So wanted implants to even this out a bit. What are the realities of doing weights twice a week with implants? (Right now, the image of the orange bikini is my ultimate wish picture) Thank you 
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