Breast Augmentation: Q&A

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I Will Be Having my Implants Sub-glandular and It Seems I Fit the Qualifications? (photo)

I have thick skin, can pinch about an inch, my nipple measures 24" from the shoulder on one side and 23" on the other. and I have quite a bit of space between my breasts. I am a low to middle B cup size My PS is suggesting high profile sub-glandular which worried me at first but then I have read my characteristics call for this placement. Do you agree?

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18 Doctor Answers | Asked by Doitorstopdreaming in canandaigua, NY

Doctor Answers (18)
Community Comments (2)

Subglandular vs submuscular breast augmentation for slightly droopy breasts

Based on both my own experience performing breast augmentation for over 26 years and much of the published literature on the subject, there are no indications for doing a straight subglandular augmentation. In fact, over the last 15 years, I have not performed a single, purely subglandular augmentation. What's more, the vast majority of revision cases I've performed have been on women wanted/needing to go from a subglandular to a submuscular positioning. In the... more

Breast augmentation above or below the muscle

Placing implants over the muscle is very rarely a good idea. You don't seem to have any of the physical characteristics or history of one that could possibly benefit from placing the implants over the muscle. The only potential benefit would be less pain and downtime after surgery which is not worth the downside of placing the implants above the muscle. You are a great candidate for the TUBA procedure where saline implants are placed via an incision on the inside of your belly button below... more

Under the muscle or Above the Muscle?

I also almost always place implants utilizing a dual plane technique under the muscle, above the muscle is certainly a quicker recovery with quicker results but there are lots of long term negatives associated with this type of placement. I would consult with a few BC PS before you make any mistakes. You obviously do not feel confident in your surgical plan so I would continue until you are confident in your surgeon and his plan.

Subglandular versus submuscular breast implants

When I started out in practice 22 years ago, I put all of my implants in the subglandular position because that is where my dad put them for 40 years. He felt that that was where your breast tissue was and therefore that was where the implants would look and behave more like your breast tissue. Although I believe he was right in theory, I have changed my philosophy over the years. Now I put almost all of my implants under the muscle. I think most plastic surgeons do... more

Sub glandular implants

I also do not place implants in the subglandular position except on very rare occasions. I am sure that you can find a good surgeon that can do so for you and you might have very nice results. I certainly have seen other surgeons' patient' in follow up with subglandular implants that look quite good even many years after their procedure. But I have also seen other surgeons' patients in follow up with subglandular implants in which the skin has become extremely thin and the implants have... more

High profile implants placed in the subglandular position may look good at first but will likely wear on your tissue over time

A word of caution. High profile implants placed in the subglandular position may look good at first but will likely wear on your tissue over time causing tissue stretching, thinning and lead to implant rippling and being able to feel the implant. To see what the best options are for you, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this... more

Sub-Glandular (above the muscle) placement of Breast Implants

There is really no advantage to placing breast implants above the muscle, in comparison to a lot of advantages to placing them under the muscle. In addition, remember that you have breast that sit far apart on your chest wall. Using High Profile implants will not help to achieve a better cleavage, as the base or diameter of the implants are smaller than a Moderate Profile breast implant.

Above or Below Muscle?

It is difficult to give you the absolute answer without a physical exam. Based on your picture I would recommend the implant be placed below the muscle. You do not appear to have adequate thickness of tissue of the upper breast to cover the implant if it is placed subglandular. Dr. ES

Sub-glandular vs. Sub-muscular

The principal advantage of placing implants above the pectoral muscle is the absence of "animation," or motion of the implant when the pectoral muscle is flexed. While that is important to a few patients, that advantage is usually trumped by the advantages of sub-muscular placement: less risk of capsular contracture less chance of feeling or seeing ripples more natural appearance at the upper pole of the implant. I don't see anything in the photo or... more

Placement

It appears that submuscular is winning and i also place implants exclusively in this plan. The pros outweigh the cons.

Michael Hueneke, MD

6 reviews

Nashville Plastic Surgeon

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Comments (2)

Doitorstopdreaming 6 Aug 2012

I need to add, I do lift weights and sometimes go pretty heavy at the gym.

Pixiepop 20 Aug 2012

I have saline implants under the muscle, I have to have them removed and will get cohesive gel implants sub-glandular. For me personally, under the muscle was not the way to go. It hurts when I work out, which i do 5-6 time/week. My PS said with a small frame he would opt to go over instead of under. I read all the doc's reviews and they all seem to opt for under for many reasons. Everyone is different, I think you should have another consult and do some more research. It's your body.

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