All breast implants can potentially have deleterious effects on patients' tissues. Limiting negative tissue consequences and potential uncorrectable deformities requires that surgeons be aware and educate patients regarding potential consequences of various implant designs. High-profile implants have been available for decades, and during the current decade, extra-high-profile implants have become available, but no valid peer-reviewed and published studies have compared the potential tissue consequences of these designs to those of other breast implant designs. Valid comparative studies are exceedingly difficult to perform because of the number of variables that must be addressed to establish valid comparative cohorts. Nevertheless, the potential occurrence of negative tissue consequences from high- and extra-high-profile implants in primary breast augmentation and breast augmentation reoperation cases is well known to experienced aesthetic breast surgeons. This article addresses potential negative effects on patients' tissues of high- and extra-high-profile breast implants used for breast augmentation. This Special Topic article is not structured or intended as a scientific article. It is written as a Special Topic and not an Editorial at the editor's request. The cases presented are selected examples to illustrate potential clinical eventualities. The rate of occurrence of uncorrectable tissue deformities relates directly to surgeon and patient awareness of the potential consequences of implant selection decisions and requests. To minimize risks of negative tissue consequences for patients, surgeon awareness, patient education, and optimal implant selection decision processes are essential.