The evolution of breast implants has brought us to a point where there is almost an individual implant for each patient. The two companies that produce implants, Mentor and Allergan, have developed implants that are suited for multiple different situations. These implants are usually referred to as low, medium and high profile and are very specific in their indications.
Low profile saline implants are represented by style 68LP of Allergan. Mentor has elected to call their low profile style 1600 implants “moderate profile.” This has nothing to do with the implant and everything to do with marketing. Low profile implants have a low projection to base diameter ratio for any given volume.
So what is the purpose of these implants? In patients who have breast fed, lost significant weight or been affected by the aging process there can be a significant loss of upper pole breast fullness. This can be demonstrated by a flattening of the area between the breast mound and the collar bone. When breast rejuvenation is performed by augmentation/mastopexy (breast lift), I use a low profile breast implant to fill this upper pole without adding too much projection.
Although many women desire this upper pole improvement, those who already have sufficient breast tissue are concerned that adding an implant will give them excessively large breasts. However, by removing a significant amount of skin for the lift and adding a small, low profile implant an aesthetic balance can be reached.
Medium profile saline implants are the “average” in implant profiles. These implants, Allergan’s style 68MP and Mentor’s style 2000 tend to fit most patients. They are designed to accommodate significant variations in breasts and bodies – which they do quite well. For both companies these implants have a higher projection to base ratio at a standard fill, than the low profile implants.
What’s unique about these implants is their ability to accept “over filling.” Previously, implants were designed to be filled to a certain point and not under or over this point. People argued that over or under filling implants could lead to premature rupture of the implant. But both manufacturers have improved on the saline breast implant by developing a silicone elastomer shell that permits a wide range of filling. Therefore, these implants can add great projection for primary augmentation, add upper pole fullness in augmentation/mastopexy, and are highly adjustable during surgery.
Finally, there are the high profile saline breast implants. Allergan’s style 68HP and Mentor’s style 3000 have, obviously, the highest projection to base ratio. In addition, like the moderate profile plus implants, they are also designed to accept over filling of the implant without danger of early rupture. In my practice I find very few instances where these will create a nice, aesthetically pleasing result.
The reason is that they don’t do nearly as much for the upper pole. Where I do think they work is in small framed, shorter women, i.e. 5’1″, 105lbs with slight frame. These women tend to not have a great distance between the breast mound and the collar bone and therefore they don’t need the added implant in the upper pole.
So there are many implants for many different situations. I think it’s improper for patients or surgeons to say “I/you need x size and style of implant!” The volume and style of implant must be determined by working together, using sizers and education. I thoroughly believe that each surgical decision must be through a mutual process. If you would like to discuss breast implants – for any reason – please click here or contact my office at 703.752.6608.