Posted by Dr. Hardesty
The “best” implant choice is based not only on volume but other important factors. One of these include the breast implant profile.
Your anatomy will dictate some of the mutually agreed upon decisions both you and your chosen plastic surgery will make. In general, if you are born with breasts close together, you’re more likely to have after breast augmentation breasts that will remain close together and vice versa.
Cleavage is largely based upon your anatomy:
- The type of breast implant (profile) placed may enhance the fullness centrally.
- If your chest is more rounded (barrel-chested) usually the breast mounds and both nipple areolar complex will rotate laterally (toward outer chest).
- Patients with pectus excavatum (a sunken central chest) will have the breast implant tend to rotate the breast mounds and the nipple areolar complex more centrally.
- And again, if you’re born with breasts close together, you’re more likely to have after augmentation breasts that will remain close together and vice versa.
Breast implant profiles are often referred to as low, moderate, high or ultra-high depending on the manufacturer’s nomenclature.
- Often patients believe that breast implant profile only relates to projection of the breast implant; however, for the same volume, the higher the profile results in a narrower base width of the breast implant.
- There is very little difference in projection between a moderate to high-profile implant, thus little effect on the perceptible final projection of your breasts.
- The base width of the breast should be the first consideration in selecting the appropriate breast implant profile.
- I personally choose the breast implant profile based on the patient’s chest measurements and breast tissue present. Therefore, a high-profile breast implant placed on a wide chest may not result in the cleavage desired, and conversely a low-profile breast implant on a narrow chest may result in enhanced cleavage but the potential of unwanted breast implant volume laterally (in the outside arm area).
Suprapectoral breast implant placement or subglandular placement — cleavage is dependent on the surgeon’s judgement for how close the doctor can dissect without causing abnormal closeness of the implants, a complication referred to as synmastia (see below) or often referred to as “uni-breast” or “bread loaf” deformity.
Subpectoral breast implant placement — cleavage is dependent on where the medial (central) origin (location) of the pectoralis major muscle is located.
In an attempt to surgically enhance cleavage, synmastia occurs when the central chest skin elevates off the chest wall, resulting in reduced cleavage and an odd non-natural breast appearance. The breasts can look like a single breast with reduced cleavage, sometimes referred to as “uni-breast” or “bread loaf” deformity. While this deformity can be corrected, it is difficult and requires additional surgery and expense.
I strongly believe in the importance of preoperative measurements to select the correct profile. While most women desire maximum cleavage, some do not. It’s only through a clear understanding of the desired size, shape, measurements and a personal examination of the existing breast tissue can the optimal breast implant be chosen to attain the personally desired augmented breast.
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