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Should I Have my Implants Placed Under the Muscle and Get a Lift?

asked 1 year ago by jenn2011
Latest answer by Tom J. Pousti, MD
Question viewed 721 times
Tags: above muscle, under muscle, natural, unsatisfied

I'm 21 5'6" 115 pounds mother of 2. I had 450 cc high profile saline implants placed above the muscle. The size is exactly what I wanted. I opted not to get a lift & now feel my areola & nipple are far to low. The size of my areola does not bother me. I was told I could achieve lift & a natural appearance with overs & the size but I feel that they look VERY unnatural & my bra straps do not lay flat against my upper chest. Will they change any more? Should I have a lift & get them placed under?

19 answers to Should I Have my Implants Placed Under the Muscle and Get a Lift?

Breast implants and lift

Hello Jenn2011, I am terribly sorry, but your photographs are textbook results of the classic bad breast augmentation Triad: too large, high profile, over the muscle!!!! As you can see, nothing short of a breast lift will acheive the results you were imagining: a beautiful breast contour with the nipple in a high position on the mound. Yes, take them out, replace with lower profile (and preferably smaller) implants under the muscle, and get a breast lift. Go... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

drminniti.com

What can I possibly say other than this is crazy?????

I have to say in all honesty that I am absolutely shocked by the result you have. Can it possibly be that you went to a real Board Certified Plastic Surgeon or was it one of those pretenders who does breast surgery without formal training (ie. a "cosmetic surgeon")? There are so many things wrong here: 1. You absolutely needed a full lift from the start. Nothing short of that would look any good from your starting point. Your breasts were too droopy to... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

This is unacceptable! Poor Surgical Judgment

I have reread your question a few times now and my answer is going to be a bit tough. As my colleague's have mentioned YOU stated that you didn't want the lift scar. OK fine, but a surgeon who possesses a decent skill set should have told you the truth. The truth being that you either get a lift or get very unhappy. Those of us that have been ethically influenced would have put on the brakes and had a serious sit down and discussed WHY you need that lift. Now you have money... more

Charles Virden, MD
Reno Plastic Surgeon

You need a revision!

Dear Jenn, I am sorry you had such a poor result but I really don't feel that all is lost. Let's start with the first problem. You are tall and thin. you don't have a lot of breast tissue and your creases are fairly high. I think that high profile saline implants do very poorly in a patient like you. Moderate profile plus or style 15 implants (gel) do much better in these cases and almost always need to be under the muscle. The problem comes in... more

Steven Schuster, MD
Boca Raton Plastic Surgeon

www.schusterplasticsurgery.com

Revisionary Breast Augmentation/Mastopexy Surgery?

Thank you for the question and pictures. Yes, you will benefit from revisionary surgery. This operation will involve mastopexy and reaugmentation ( preferably in the sub muscular or dual plane position). Given your negative experience thus far, I hope you will take your time and do your due diligence given that the revision surgery is relatively complex. Make sure your selected surgeon has significant experience that he/she can demonstrate to you. Best wishes. more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Need a lift? Replace breast implants?

What your surgeon chose to do in your case makes no sense whatsoever. Where to begin. It is obvious from your photos that you needed a lift, and that would be a full lift and not a minor lift with just scars around the areola. Putting implants in the breast will fill it out but it will NOT LIFT THE BREAST! Putting really large implants in the breast will really fill it out BUT WILL NOT LIFT THE BREAST! Saline implants can look less natural than silicone gel implants, in... more

Robert M. Grenley, MD
Seattle Plastic Surgeon

Breast lift with implants

The position of your implants is not the main issue You need a vertical breast lift .I would replace the saline implants with moderate plus silicone gel,my preference is subfascial.You may also consider slightly smaller implants

Hilton Becker, MD
Boca Raton Plastic Surgeon

Follow the advice of your doctor.

I am sorry you are not happy with your breast augmentation. From your photos I can understand why. Even though it is sometimes hard to follow the advice of your surgeon, especially if he/she is telling you that you need a lift, it is generally better to follow their advice. You DO need revision surgery. Time is not going to solve your problem. The difficult thing is that it may be too risky to perform the implant repositioning and the lift at the same time... more

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon

Alll is not lost

There were a number of poor decisions made by your surgeon as mentioned by my colleagues, but what are you to do now? Start by seeing several board certified plastic surgeons for examinations and advice). Look for a surgeon who does a lot of breast lifting; not just augmentations. It is a technical and demanding procedure and not the same as augmentations alone. I would recommend moderate plus profile silicone gel implants placed under your chest muscle... more

Lori H. Saltz, MD
San Diego Plastic Surgeon

www.ljcsc.com

Should I Have my Implants Placed Under the Muscle and Get a Lift?

The only change you should do is find another , at least boarded,PS to revise this unacceptable result. Sorry for your issues. Yes a full lift the sub muscular placement is in order.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Should I have my implants placed under the muscle and get a lift?

The preoperative evaluation of your breasts is extremely important. Your photographs clearly show that your nipples are present at the lowest pole of the breast and the diagnosis for this appearance is called "severe ptosis". Patients with severe ptosis need a breast lift procedure. I would put new implants under the muscle with a lift. You were very clear that you liked your size and that should be respected. Being extremely thin, your... more

Elizabeth S. Harris, MD
San Antonio Plastic Surgeon

Breast revision

Sorry for your unhappiness. It looks like you needed a lift from the beginning and I think that the implants may be too big for you as well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Bad result after breast augmentation.

Your result could have been easily predicted from your preoperative photographs and decisions made regarding how to perform your breast augmentation. A breast full breast lift with augmentation should have been your initial surgery for best results, and your surgeon may have explained this to you. Always consult with a board certified plastic surgeon for breast implants, augmentation, and revisions. Other types of surgeons usually cannot offer alternatives such as a lift at the same time as... more

Frank Agullo, MD
El Paso Plastic Surgeon

www.elpasoplasticsurgery.com

Placement of Implants with/without Lift

Despite your happiness with size of your implants, I think that they are probably a bit large for you. If that is the case, it will be very difficult to achieve a natural look. You did not state how far post-op you are (it appears that you still have a dressing in place). It is possible that you may still see your implants drop somewhat which will be helpful.

John Whitt, MD
Louisville Plastic Surgeon

This was a poor choice of procedures.

No Question, the correct thing to do is to move the implants to under the muscle as well as have a lift. I think this will give you by far the best shape, with the same size and a much longer lasting result. As far as the timing of the surgery..... I would remove your current implants as soon as possible before your skin stretches as the implants settle. Don't wait for things to worsen as they settle. I would move the implants to under the muscle and perform the lift... more

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Breast lift following augmentation

Placing your implants behind the muscle helps to camouflage the upper poles of the implants, however high profile saline implants, by design, almost never look natural. Their design is to create a high, round appearance to the breast, which by definition is unnatural. Placing implants above the muscle does not lift the breast, it allows the implant to settle into the breast skin envelope, leaving the entire breast lower on the chest. As you are only two and a half weeks... more

Craig S. Rock, MD
Houston Plastic Surgeon

You will need lift as your surgeon Sugested

Your breast results are very predictable based on the before pictures. You and your surgeon chose not to do the lift and that is ok to do it in two stage. I would have suggested lift first and implant later. Very often patient does not want the lift scar and surgeon agrees to do the augmentation on a patient that needs lift more than augmentation. The only caution is that you are at higher risk of nipple necrosis after lift due to the implants position. You may have better results to wait... more

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Can implants lift breasts?

Dear Jenn2011, From your statement, it would appear that were given the option of a mastopexy before your operation but declined that option. Many women are appropriately concerned about the added scar burden of a breast lift. You seem happy with the volume of your breasts. Not choosing a lift resulted in the "unnatural" appearance of your breasts. Many plastic surgeons do a breast augmentation in stages. For example, doing a augmentation first... more

Craig Harrison, MD
Tyler Plastic Surgeon

Should I Have my Implants Placed Under the Muscle and Get a Lift?

I concur with dr Rand. Your breats have the "snoopy" deformity and will require a breast lift . Whether the implants are above or below the muscle or sub fascial will depend on your surgeon's experience and judgement and the type of implants chosen.