Breast Augmentation: Q&A

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What's the Best Kind of Breast Augmentation Procedure?

On some breast augmentation boards, many ladies rave about putting the implants fully under the muscle since the muscles fully support the implants and help prevent them from bottoming out and wrinkling.

Also, there's supposed to be less risk of CC's (Capsular Contraction) with this placement plus, even in very thin patients, implants are hardly visible and palpable. I really like the idea, together with the idea of transaxillary incision, but the surgeon I have chosen doesn't share my enthusiasm.

In his opininon, lower implant pole will not look natural and the muscle will never stretch for implants to expand. We have also discussed placing last 1/3 under fascia but that seems to be the problem when using transaxillary incision. What do other experts think?

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9 Doctor Answers | Asked by Zulu in Sydney, AUSTRALIA

Doctor Answers (9)
Community Comments (1)

The best augmentation is what you feel is right for you

I too like to keep the scar off of the breast if possible and I feel the transaxillary or underarm incision is a very good choice. From this incision the implant can be placed under the muscle, or over, though we favor a submuscular implant because the capsule contracture rate is significantly lower. Despite your surgeons fears the lower pole coverage will be satisfactory, and through the transaxillary approach the lower attachment of the chest muscle should be released as the muscle... more

Thorough exam and evaluation for breast augmentation necessary

Thanks for your questions and points. It is imperative that you consult with a plastic surgeon that is experienced in breast augmentation. There are always advantages and disadvantages with any operation and this holds true for breast augmentation. A thorough examination and evaluation is required to determine what is best for you! I hope you find this helpful!

"Overs" or "unders" implant placement

This is a question that is repetitively asked for good reasons but has no answer. Take it for what it is worth but I last heard that about 80% of surgeons prefer "unders". Even the surgeon who made the transaxillary approach popular does not perform that approach in the vast majority of his patient's. This is my simplified analogy without getting too scientific: It is the surgeon's responsibility to make you aware of the risks and alternatives. The surgeon has to show you the... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Techniques of breast augmentation surgery

Every patient is unique and may vary in which option would be best for their particular or specific case. However, it does depend on the individual's body type, the size of the areola, and the internal anatomy as well. Most of the time, I recommend the peri-areolar incision. This incision is beneficial because the tissue of the areola is vry forgiving compared to the regular dermis. The scar tends to fade as a fine line incision over the course of time. As with any scar, the incision... more

Best Breast Augmentation

I am not a believer of a full muscle coverage of the implant. I have seen numerous patients that have had that done only to see that their breast tissue has fallen over the implant and the implant appears to be sitting too high.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

I lean towards your position.

I prefer the under the breast incision for a number of reasons including good scar, excellent access, low complication rate, ability to precisely the implant, etc. I place the implant completely under the muscle, and I invite you to look at my results (www.drkasden.us). There are things that can and are routinely done by myself to ensure optimum shaping of the final breast mound. Finally, I strongly believe in the submuscular placement. It reduces riskes of cc, sagging, ripples. It... more

Find a plastic surgeon whom you trust.

Hi! Ask to see lots of before and after pictures. Then let him do what he or she thinks is best. Don't tie the surgeon's hands. Maybe an axillary approach is not best for you. And I get great results putting implants over the muscle in the right patients. The outcome in breast augmentation is NOT determined by whether you put the implants over the muscle or under the muscle or partially or under the fascia. And it is not determined by what implant you use. It is determined by the planning... more

Each surgery needs to be individualized for each patient

There is not one right answer. The reason why there are so many different options is because different people need different procedures. Without seeing your photos or examining you, it is hard to tell for sure which is the best option for you. It sounds like your surgeon is giving you good and realistic advice. Good luck with your surgery.

There is no such thing as best...

Breast augmentation is an imperfect operation. Each choice you make will affect the potential side effects and complications. Each patient and surgeon will have different opinions on the different characteristics of the breast as regards size, shape, texture, proportion, relative complications, etc. There are so many factors and variables to consider that one method or one result cannot be consider better or worse than another. A rippled result is no better or worse that a firm result. You... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

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Comments (1)

ms.christina77 28 Aug 2012

My implants 616cc, where put in under my arm pits. It was very painful, but worth it. I can deff say Im so glad I had them put in this way! Deff look into a surgeon that does this technique.

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