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Is It Better for an Implant to Go over or Under in a Tubular Breast?

asked 2 years ago by gypsyrose87 in PA
Latest answer by Steven Wallach, MD
Question viewed 617 times
Tags: breasts, tuberous

During my consultation, my doctor suggested a lift on my larger side and two different size implants to deal with my severe asymmetry of 200cc. My smaller breast is also tubular. My doctor suggested that the implants go over the muscle. Is over or under better for tubular breasts?

My family also has a history of breast cancer. Both my aunt and grandmother had it. My mom was tested for it and she found out she was not a genetic carrier but that doesn't mean that she or I won't get it. What kind of difference will it make to have the implant go under the muscle vs. over?

14 answers to Is It Better for an Implant to Go over or Under in a Tubular Breast?

Over or under for tubular breasts

I prefer in most cases to place implants under the muscle in a dual plane approach( the lower part really under the breast tissue).

Steven Wallach, MD
Manhattan Plastic Surgeon

Is It Better for an Implant to Go over or Under in a Tubular Breast? DO BOTH

Is It Better for an Implant to Go over or Under in a Tubular Breast? Generally, I prefer to the dual plane approach in which the gland is released above the muscle but the implant is placed below it.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Implant placement in tubular breasts

As Dr. Baxter nicely said, I also like to place the implants under the muscle and since the result is very difficult to get perfect on the operating table with tubular breasts, I like to use the post-operatively adjustabe saline implants so we can modify the size and symmetry for several months after surgery until it gets as close as possible.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Augmentation in the tubular shaped breast

For individuals with a tubular breast on both sides, in general we would recommend a submuscular implant. The reason is that the breast is small by nature, and has a tightness below the nipple and smaller diameter. The submuscular implant gives better cover and keeps the implant hidden as the skin relaxes and thins over the implant. Often we use a round block suture around the nipple to reduce the forward prominence, also called a 'herniation' of the nipple. I responded to your last... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Correcting tubular breasts- over or under the muscle - not Breast Aug 101

Tubular breasts are a difficult problem. You can see by the varied recommendations of some of the finest surgeons below that there is no consensus on how to treat them. In general , we have several theories about tubular breasts. 1. The lower pole of the breast is tight. We must respect that and not try for too large of an implant. Excessive scoring of the breast can kill the nipple or make it insensate. I have personally seen cases where this happened. 2. I prefer under the muscle... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Your doc is right, over the muscle and under the breast is best with tuberous breast

In my opinion it is best to reshape the breast through a peri areolar incision and place the a silicone gel implant implant under the breast and over the muscle. Often it is a good idea to do a nipple areolar reduction because they are often large with pseudo herniation of the breast tissue through the nipple areolar complex.

Carl W. "Rick" Lentz III, MD
Daytona Beach Plastic Surgeon

Breast implants need to go over the muscle to correct tubular breasts.

Hi. I think I answered another question of yours. When breast implants go under the muscle, they increase size but do not help with shape, which is the main problem in tubular breasts. Your doctor is right. With an expert mammographer, you can get good examinations to detect an early breast cancer.

George J. Beraka, MD
Manhattan Plastic Surgeon

Implants for a patient with tubular breasts

Hi there- Because the benefits of placing the implants under your muscle are so compelling, I would recommend this position for you, despite the tubular shape. Given the tubular shape and your asymmetry, a dual plane technique would be best.

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Prefer under in a tubular breast

Again without photos very hard to tell. But I always recommend 2 stages of surgery. I would prefer to go under the muscle. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Tubular breasts can be corrected with implants

Hello - Yes, tubular breasts can be corrected with implants over the muscle. However, if extensive work will be done around the areola you may want to get the implants under the muscle to prevent any blood flow problems to the nipple-areola area. As far as your risk for breast cancer, check with your family physician about getting tested for the gene. You may want to consider a mammogram before any breast surgery as a baseline to compare with future mammograms. Good luck!... more

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

www.BaltimorePlasticSurgery.com

Under muscle implants preferred for breast cancer screening

I am sure you are aware that the plastic surgeon who examined you is in the best position to give specific advice, but here are a few general statements that may be helpful: Since you are concerned about breast cancer, most radiologists feel that they get a better mammogram with implants under, though how much better is subject to debate. On a practical level, when implants are placed with a breast lift at the same time they usually go under, since the blood supply is preserved better that... more

Richard Baxter, MD
Seattle Plastic Surgeon

Tubular breast deformity and implants

Tubular breast deformity is a difficult problem. Over versus under the muscle depends on your exam, and I have often opted for over the muscle in this specific group of patients. This is a little more complicated in your case, as given the family history of breast cancer, going under the muscle will allow better visualization of your breast tissue on mammography. I would let your doctor know of your family history, and therefore you will be able to discuss the risks and benefits of both... more

Nina S. Naidu, MD
New York Plastic Surgeon

Tubular breasts and implant placement

Generally speaking, it is "safer" for implants to go under the muscle since it affords one extra layer of cover, separates much of the upper implant from the breast gland, and reduces risk of hardening leading to better mammograms. However, becasue we use the implant to influence the shape of the tubular breast, the closer the implant is to the skin, the more it can influence that shape so often we will put implants over the muscle. This is an individual decisions based on the... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Tubular breast reconstruction

For most cosmetic indications, breast implants are best placed under the muscle. However, sometimes with tubular breasts you actually get the best result from over the muscle placement or, if placed under the muscle a dual-plane II technique to radial scoring of the breast tissue. I hope this is helpful.