Understanding Implant Profiles in Breast Reconstruction

Breast implants come in different profiles. If you have multiple 300cc implants, a low profile implant will be wider and flatter. The next profile, moderate, will be a little narrower and a little more projected, and so on.

With breast reconstruction, we tend to use implants that are higher profile because we're not augmenting a breast — we're completely replacing it with the implant. Those patients need more projection, so it's more common to use high or extra high profiles in this patient population.

The implant that's chosen should not be chosen based off the profile. It should be chosen based off of your anatomy and your size goal. If you have a 400 gram breast and we want to replace it with a 400 or 450 gram implant, that implant needs to fit the footprint of your breast, and that will dictate what the profile is.

Your surgeon should have your measurements, we should know the volume goal, and we look at that chart and we pick something that's going to fit your anatomy. It could be a moderate, but it also could be a high or extra high.

One of the biggest mistakes I see is surgeons using the wrong profile implant. They choose a higher extra high profile implant because it's a reconstruction and "you need that," and the implant is too narrow for the chest wall and it ends up looking bizarre and often tuberous.

In my opinion, the surgeon should never be having you choose the profile. The profile should be chosen based off of your volume goals. The volume as a patient and a woman is the most important thing — the volume you have really dictates your proportion, how you fit in clothing, and I think that's the most important variable. Then we choose the profile to fit your anatomy so it looks the most natural.

I always caution people with jumping to the extra high or high profile implants, especially if you really don't need that implant to fit your anatomy, because they're much more likely to rotate. This is much more common with the reconstructive population, especially if your surgeon uses dermal matrix or no scaffolding at all.

When you've had a mastectomy and reconstruction, the breast has never peaked the shape like a natural breast. It's always a bit flat in the central portion — that's just because of how implants are shaped. Surgeons will sometimes recommend a higher profile implant to fix that problem, but they're still going to be flat in that area. And if the implant doesn't fit your anatomy, it's just going to look weird.

Those are just some quick thoughts on profile and breast reconstruction. If you're considering breast reconstruction, feel free to reach out with any questions!