This decision depends as much on what the surgeon can accomplish using either the round or the anatomically contoured implants as on which type of implants to use. Assuming the breast pockets are dissected in to the inferior or lowermost extent in the exact same manner, the shaped implants will impart more fullness at the top, and provide a more natural, gently curving slope to the augmented breast. For this to happen, however, the lowermost portion of the dissection or pocket must be the same no matter which mammary implants you use. If a surgeon habitually dissects low enough inferiorly to drop round breast prosthesis low enough that upper pole fullness is lost, that surgeon will likely favor the teardrop shaped, or anatomically shaped implant to compensate for that dissection. For anatomically shaped or contoured implants to do what they were intended for, pocket dissection has to extremely precise. This is because contoured breast implants are not symmetric; they have a top and bottom. If the subglandular or submuscular pockets are too wide, the shaped implants can shift or even flip, imparting asymmetry and even worse an unnatural shape to the augmented breast. Even though shaped mammary implants are textured, this is still no guarantee against malposition. Finally using the round type of breast implants can impart more medial or inner breast fullness. This significantly improves cleavage, because more fill volume winds up toward the more central part of the breast.
There are several advantages to the use of high profile breast implants. First, just as the name suggests, for any given fill volume, high profile breast implants will implant more projection or profile when compared to moderate or “normal” breast prosthesis, and most certainly more than low profile, or anatomically shaped breast implants. The way to picture this is that if you had a cone with a highly sitting tip versus a cone with a wide base, the narrower, taller cone would point more (think of Madonna’s show bra!) and thus give more projection to the breast. What this means is that women with a narrower, smaller chest wall can still have larger breasts. The advantage to some women, and disadvantage to others comes from a basic difference in perception as what a natural breast should look like. If a patient prefers a highly “perky,” high profile, or well projecting breast, the high profile breast implant would be considered ideal. High profile breast implants would not be ideal to place in a patient who prefers natural, gently sloping, and slightly ptotic (hanging) breasts, or in a client who is large and wide chested. Placing full profile breast implants in the case of a wide chest would impart a very unnatural “double cone” appearance. For women with a mid-range chest-wall diameter the choice is one of partiality. That is, the decision has to be made between projection, and cleavage. This is because lower profile implants with a wide base will naturally fill up the inner, otherwise known as the medial breast, and produce cleavage. Finally, it is mostly the anecdotal opinion of some authorities that full or high profile implants tend to generate less rippling.