Since a breast implant does most of the ‘work’ of accomplishing a breast augmentation result, it is understandable that patients have great concerns about the size and style of the implant for their surgery. There are numerous methods for selecting the size of the implant and these issues have been addressed since the inception of breast augmentation surgery. The newest variable (option) in breast implants is that of projection or profile, of which there is less established methods for determining whether one should have a high or low projecting breast implant.
Projection (I shall drop the term profiling from here on) is where the shell of the breast implant is altered, given the same volume, to allow more fullness outward at the expense of narrowing the base diameter of the implant. This can be theoretically useful when either one wants more fullness at the top or superior pole of the breast result or is concerned that the size of the implant may be too wide for one’s chest. (avoiding too far lateralization of the implant) Some contend that a higher projecting implant may help with a low nipple position or minor degrees of sagging although that purported benefit may be more theoretical than real.
While the shape of a breast implant is important, it is often give more credit that it should for what it can do. A very important component of how any implant changes the shape of the breast is the amount of breast skin present and its quality. I believe this has much greater impact on the augmentation result than any type of implant projection. If one wants naturally devoid of much braest tissue and has tight skin, the final augmentation look will likely be more full and round regardless of the implant projection used. Conversely, a loose and floppier breast will likely look more tear-dropped shape or saggy even when a high projecting implant. (unless one gets a very big implant)
While the morphology and size of a breast implant gets much scrutiny, it is just the synthetic part of the breast augmentation result. The natural or tissue part of the procedure is in many cases far more important as to what the breast shape outcome will be. Patients need to be carefully counseled about this issue so that their expectations are in line with what can realistically be accomplished given the anatomy that they have.
Dr. Barry Eppley
Indianapolis, Indiana