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Is Above Muscle Breast Implant Placement the Best Approach?
I am 37 years old and have nursed my 3 children. I used to be a C cup, but now my breast are just "empty" and saggy. My surgeon says I am not quite needing a Breast lift, but is recommending Silicone Breast Implants above the muscle. I don't know anyone with implants above the muscle. Is this the right approach?
Asked 30 months ago by
weejo0 in Kansas City, KS
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Under the muscle is best
Surgeons are divided on the topic of implants on top of the muscle vs. under the muscle. There are several disadvantages of implants on top of the muscle including more sagging over time, easier to see and feel the implants, higher risk of capsular contracure, higher risk of rippling, more interference with visualizing breast tissue on a mammagram and more risk of the nipples losing their blood supply with a future breast lift. These problems far out-weigh the scars from getting...
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Breast implant placement
Most breast implants are inserted under the pectoral muscle (subpectoral). The reason for this is a lower rate of capsular contracture (scar tissue), more natural appearance, and easier mammogram interpretation. This is not to imply that over or in front of the pectoral muscle is incorrect, however there are many more advantages with the subpectoral approach.
In your particular case, the recommendation of placing the implant in front of the muscle is likely to avoid any need for a breast...
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Placement of breast implants below or above the muscle
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Above vs below the muscle augmentation
By the image you posted, you have some laxity of your skin and some mild asymmetry as well. My personal preference would be to place your implants partially under the muscle with what is referred to as a dual plane release (relasing a bit more of the muscle). This would lend you a better upper and middle breast coverage but I would have to examine you to see if this is OK without some form of a lift. It depends as well on the size implant you chose too.
I rarely perform above the muscle...
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Above or below the muscle breast implant placement?
It is hard to answer by just looking at one photo, but it is important to understand there are 2 options: above or below the muscle.
My preference is below the muscle, but what you probably need is an implant placed in a dual plane, which means the implant is partially under the muscle. The upper 2/3's is covered my muscle and the lower 1/3 is not. The choice between saline and silicone is personal, and you should be well informed of the pros and cons of both.
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Going Above the Muscle Has Some Advantages
Because you have some sagging, many surgeons may opt to place your implant above the muscle to allow more appropriate placement of the implant beneath your lower breast.
The downsides are a slightly increased chance of capsular contracture and possibly a more visible implant edge or "break" between the chest wall and breast at the top. A gel implant will lessen that last issue, though.
A board-certified plastic surgeon will be able to decide this upon examining you....
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Breast implant placement is matter of opinion
Hello,
Much of that which you will find in plastic surgery is a matter of opinion. Over the muscle silicone gel implants have a higher rate of encapsulation (getting hard) over the long term. Then again they ripple less and you are thin. Even "under the muscle" implants in your case will probably be only about half under the muscle.
These things are topics to discuss in pre-op so you can decide what is best based upon your preferences. Little of this is "set in stone."...
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