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Complete Submuscular Placement? Scared.

I am having breast implant surgery on Feb 8th 2013. My surgeon wants to do complete underst not just pectoral. I am having 625cc's and I worry that they will sit too high. Or is it because of the large implants that it will be fine? I am 5'4, 130, medium frame. Can I ask my surgeon to do partials on the day of surgery? My nipples are low and he says they will always be low without a lift but wouldn't the sub pectoral help fill the lower pole? Is my implant too large for the sub pectoral?

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18 Doctor Answers | Asked by minkygurl

Doctor Answers (18)
Community Comments (1)

"Submuscular" Implants

Your surgeon must mean a dual plane procedure? Meaning partially sub-muscular. It would be difficult if not impossible to place this size implant under the muscle. AT 5' 4" and 130 lbs. If your nipples are low they will stay low and risk being even lower with such a large implant unless there is a lot of skin between the bottom of the areola and the infra-mammary fold. Is the big implant an attempt to fill out a very deflated breast? When a patient needs a breast lift I will not substitute a... more

Complete Muscular Breast Implant Placement Concerns?

Thank you for the question. I think that you will benefit from additional time spent with your plastic surgeon in the office days prior to surgery. I would suggest that you not wait on having these types of conversations until the day of surgery. Although I do not know your situation precisely enough to give you specific advice, my concern with “complete” sub muscular augmentation is the increased risk for animation or flexion deformity; these terms... more

Implants

If you need a lift unless you have pseudo ptosis then you will still need a lift afetr breast augmentation

Complete submuscular breast implants

I wasn't aware that anyone was still even trying to use total submuscular implant placement in cosmetic breast augmentation. That was tried back in the day when it was thought that there was something magic about being under muscle that prevented capsule contracture. The technique doesn't work and certainly not with large implants. I suspect 625 cc implants are too big for even under the pectoralis muscle with a dual plane release and that they won't fit or look right. To fit and fill out... more

Breast implants

Those are pretty big implants and will not be a provide suitable lift, if that is actually what you need. The sub muscular issue is an entirely separate one altogether. I do prefer the sub muscular placement but I don't think there is much if any difference between the so called partial versus the complete muscle coverage.

Submuscular vs subpectoral

There are many issues to resolve before sugery: this is a large implant how big do you want to be submuscular would be tough biplanar sould be considere a small lift to reposition the areola may be worthwhile

Complete Submuscular Placement? Scared

I would be scared too. I honestly don't think it is possible to get full muscle coverage of an implant so large in a patient of your size. The day of surgery is not a good time to change plans, as some thought and consideration will be required of both surgeon and patient. Now is the time. Without a photo, I cannot comment on the issue of nipple position. Call your surgeon today to discuss. Thanks for your question, all the best.

Submuscular implants

Hello Minky, You must have been mistaken (I hope) about what your surgeon said to you regarding a full submuscular pocket. You simply cannot place anything more than a very small implant completely under the muscle in one surgery. Aside from the large and capacious pectoralis major, the other muscles required to make a true submuscular pocket (pectoralis minor, serratus anterior, and rectus abdominus) don't stretch that much, and trying to do so will simply tear them... more

Complete submuscular placement is not done for breast implants.

Hi. 1) There may be a miscommunication. Complete sub muscular placement is only used for post mastectomy breast reconstruction. And you are right that the implants would sit higher. 2) You did not ask this, but we never use breast implants larger than 500 cc's for breast augmentation. see video

Completely submuscular breast augmentation

Your concerns are legitimate and due to these issues, I would highly recommend further consultation with your plastic surgeon again, prior to your surgical date. I am concerned that implants of that large of a size would fit in a completely submuscular pocket, especially in the body habitus you describe - a clarification of the definition of "submuscular" should be discussed. In my experience, implants truly in the submuscular pocket do "ride high" since the insertion of the... more

Subpectoral vs. Complete Submuscular Implants?

I have concerns about the plan. You need to meet with your surgeon again before the day of surgery. I am not a fan of complete submuscular since the implant may be prevented from settling into normal position. I am not sure why this is recommended, especially with large implants.

Unsure about total submuscular or subpectoral implants

My advice would be for you to contact your surgeon as soon as possible to arrange a further pre-operative discussion BEFORE your operation day. It is generally a bad idea to make changes in a planned elective procedure on the day of surgery. You should make sure you clearly understand the options, risks and benefits before undergoing surgery

Complet submuscular too high?

You are absolutely right. I never put them completely submuscular because the muscle will force the implant superiorly. I have had to fix other doctors' mistakes regarding this on patients whose breasts literally fell over the implants.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Complete Submuscular Placement with Large Breast Implants

Your concerns about your upcoming breast augmentation procedure are understandable and you should go back to clarify these issues long before the day of surgery. A further explanation of what the definition of submuscular implant placement means and where exactly a large implant of 625cc is going to go merits additional discussion. I would think it would be very difficult to get such a large implant completely under the muscle in someone of your body frame size.

More consultation required

Without a physical examination, and no pictures, I do not have enough information to answer your question. However, your plastic surgeon does, and should be able to answer your questions. Call your surgeon on Monday, and let them know that you still have questions and concerns. This should have been sorted out at your preoperative appointment, but definitely needs to be sorted out before surgery. Do not wait until the day of surgery. You deserve to know what is being done, why it being... more

Joseph Mele, MD

4 reviews

Walnut Creek Plastic Surgeon

www.DrMele.com

IMPLANT POSITION

Without photos and measurements is is difficult for a consultant to give you honest recommendations. You need to sit down with your surgeon and iron out your concerns. A second opinion my be helpful.

Dual plane versus complete submuscular

Personally, I'm a fan of dual plane placement, except in women who are very skinny. The drawback with complete muscular coverage is the motion you get of the implant when you activate your muscles, causing the implant to move. This problem, known as "animation deformity", happens a lot less with the partial coverage technique. Talk to your surgeon well in advance of your surgery date.

Complete Submuscular Coverage

The only way to achieve complete submuscular coverage would be to elevate both the pectoralis major muscles and the serratus anterior muscles and suture them together. The truth is that breast augmentations under the muscle are never totally under the muscle. Sometimes, very little of the implant is under the muscle, depending upon anatomy and what is need during surgery. The lower pole can be adjusted by a skilled surgeon to accommodate almost... more

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Comments (1)

minkygurl 10 Feb 2013

I have already had this done. I wasn't mistaken. I had the full unders. With full submuscular, the implant is placed below the pectoralis major, the pectoralis minor, the serratus and the fascia(connective tissue covering the muscle)of the rectus abdominal muscles of the abdomen. He lowered my breast crease which has added to my pain. I am wrapped so tight in an ace bandage its ridiculous, its hard to breath.The bottom can be lifted up and I can see the bottom half of my breasts. They are badly bruised I cannot see my nipples they are bandaged because that's where my incision is. PS won't see me until Valentines day. The pain is unbearable. I cannot go on this way. Please help me.

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