Which Implant Placement is Better for Tubular Breasts - Submuscular or Subglandular?
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Breast Implant Placement in Tuberous Breasts
Regarding: "Which Implant Placement is Better for Tubular Breasts - Submuscular or Subglandular?"
Let's first understand WHAT happens in tuberous breasts (they look like roots or tubers). The breasts are literally bound by circumferential bands of fibers which prevent the breast from achieving its dome like appearance, the areola is usually enlarged with a varying degree of fullness due to fat herniation into it.
To correct this deformity, we usually enter the breast via an incision around the areola (which allows narrowing the areola if too large) and allows cutting and release of the constricting bands. Once the bands have been cut, the breast is like an umbrella which just began to open. It takes the fullness of the implant UNDER the breast (just like the umbrella slide being moved up to the highest point on the rail) to spread the released breast over the implant.
Breast implant placement depends on the particular woman. In women with LARGE tuberous breasts an implant MAY be placed under the breast gland. But in women with a small amount of breast tissue we prefer to put the implant under the muscle to cover the implant and avoid visible and palpable folds.
Dr. Peter Aldea
Breast implants under vs. over the muscle
The question will be answered differently by different surgeons. Those who prefer under the muscle will say under the muscle and those who do not will say subglandular. However most will agree that with thinner leaner patients under the muscle is better. With respect to tubular breasts the most important component is performing the necessary surgical procedures on the breast tissue and skin as needed.
Breast Implant Placement for Tubular Breasts
Tubular breasts are some of the most difficult and unpredictable breasts for breast augmentation. Placement of the breast implant over the must allows faster stretching of the breast tissue by the implant which will help to form the breast into a normal shape. the draw back is that breast skin will continue to stretch and patients get early sagging. Placement of the implant under the muscle is preferable in the long term, but it does take longer for the muscle and the breast skin to stretch out with the implant.
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Correction of tubular breasts
I generally prefer submuscular placement of implants, as that position gives more tissue coverage over the implant. An implant alone will not correct a tubular breast shape--additional surgical maneuvers are necessary. However, an implant will help to stretch the tight lower pole of a constricted tubular breast.
Implant Position for Tubular Breast
Each surgeon may express a different preference for implant placement.
Generally, I prefer submuscular.
The key to success is the redraping and reshaping of the breast, using the implant to help expand the breast.
Treatment of Tubular Breasts
Thank you for the question.
Tuberous ( constricted) breasts are characterized by a wide spectrum of presentation including constriction of the breast base, glandular and skin hypoplasia (especially at the lower quadrants), mal-position of the infra-mammary fold, breast tissue herniation into the areola region and sometimes increased areola diameter.
Generally, correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.
In the most severe cases of tuberous breast, a more complete breast lift may also be necessary. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.
Although every surgeon may have their own preference, I would prefer to place the breast implants in the sub muscular (dual plane) position if at all possible to minimize risks associate with breast implants placed in the sub glandular position.
Probably more important than breast implant positioning, is selection of a surgeon who has significant experience treating constricted/tuberous breasts.
Best position for tubular breasts?
I hav e found the use of the dual plane (both under AND over) to be useful in the management of tubular or constricted breasts.
Web reference: http://www.bodysculptor.com/breast-surgery-chicago/
Implant Placement for Tuberous Breasts
Because a tubular breast shape is fundamentally a deficiency of skin and tissue, I believe a subpectoral placement is best.
Having said that, the only way to get accurate, responsible advice would be to find a good plastic surgeon you feel you like and can trust and visit for a consultation.
Preferred placement of implant for tubular breast deformity.
Due to the nature of a tubular breast deformity, the implant is most commonly placed under the muscle. This helps camouflage the implant and allow it to appear less visible. Multiple issues are apparent in the tubular breast deformity including herniation of breast tissue into the areola, tight constricting bands within the breast, an elevated inframammary fold, and a paucity of lower pole breast skin. In extreme cases, a tissue expander may be necessary to expand the lower pole skin. Some plastic surgeons are also using dermal matrices to reestablish the proper height of the inframammary fold and to support the implant internally and prevent additional thinning of the already compromised lower breast pole. Tubular breast correction may be cosmetic in its goal, but it is truly reconstructive in the surgical planning.
Web reference: http://www.drbogue.com
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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