Which breast implant profile is best? Demystifying terminology

Low profile, moderate, and high profile breast implants mean different things to different implant manufacturers. For example, Mentor’s 300 cc “Moderate Plus” smooth silicone gel implant has a base width of 12 cm, identical to Sientra’s “Moderate” profile gel implant. Add the further option of shaped (form-stable, anatomical, gummy bear, cohesive) implants and the choices seem more confusing still, not to mention that the size/profile options for textured implants vs. smooth and saline vs. silicone gel are not always the same.

So is there a simple way to make an intelligent decision about which implant profile is best? The first step is to ignore the terminology and look at the numbers. Regardless of the size (volume) of the implant, is has to match the existing base diameter of the breast. This is the reason why different profiles are made; the profile reflects the projection of the implant, so for each diameter the implant gets larger with greater projection. Low profile is more flat, high profile more cone-shaped. For example if a 12 centimeter base width is the best match, but you want larger volume than the 300 cc implants mentioned above, Sientra’s “Moderate High” would get you to 400 cc, or for a smaller volume Allergan's Style 10 (low profile) at 270 cc/12.2 cm base width might be best.

The best approach in my experience is to select the desired volume first, using sizer implants placed into a bra of the desired cup size. Since the implants will just adapt to the bra shape when placed in a bra over the breast, you get an idea of size without worrying about base diameter or profile at this point. Once this is determined, then the base width for that volume determines the profile (in addition to other considerations.)

There are other factors to consider, such as fill volume. Some manufacturers offer silicone gel implants with a higher fill (as a percentage of maximum) so the implant can actually have a larger volume with the same base width and shape. This means less tendency for rippling but perhaps a firmer feel. This may be more important for higher profile implants (regardless of what they are called) which tend to have more upper pole ripples, called traction rippling.

There are some general guidelines, such as high profile might be more “fake” looking, low profile is a good choice to add upper pole fullness with a breast lift without too much volume. The biggest trap is trying to fine-tune the decision too much. A 15 cc difference is only a tablespoon, and cup size just does not translate to implant volume or profile very precisely. So in the final decision it isn't really about the numbers either.