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Should Petite Woman Go Sub Glandular or Sub Muscular?

asked 1 year ago by Atlanta GA7934 in Atlanta GA
Latest answer by Tom J. Pousti, MD
Question viewed 363 times
Tags: implant size

I have had one surgeon recommend silicone, sub muscular. Another suggested silicone sub glandular. His reason was that I have no fat, and not a very thick chest wall, meaning there won't be a discernible difference with either approach. I am 5'3" ! 107 lbs. He also said current data shows no difference in incidence of capsular contracture based on placement- even though that was widely believed for many years. I am considering 250-300cc.

18 answers to Should Petite Woman Go Sub Glandular or Sub Muscular?

Position of Breast Implants?

Thank you for the question. I think it is in your best interests (and that of most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

"Pinch and Inch" General rule for over or under breast implant augmentation surgery

If you can pinch less than an inch of tissue on your upper breast or you can clearly see your ribs, you should place your implants under the muscle.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Always go submuscular to avoid capsular contraction

I would always recommend going submusclar when possible because placing the implant subglandular increases the chances of capsular contracture by up to 50%.

Usha Rajagopal, MD
San Francisco Plastic Surgeon

www.sfcosmeticsurgery.com

Subglandular vs submuscular

I recommend sub-muscular implant placement. I really can't think of many reasons to recommend subglandular placement; there are few indications.

Samer W. Cabbabe, MD
Saint Louis Plastic Surgeon

Should I go above or below the muscle

From the answers already provided, you're probably figuring out that the consensus that for a petite thin woman with very little breast tissue, the most optimal placement of a breast implant is under the muscle. Definitely go with silicone gel since saline is almost guaranteed to ripple over time and will look much less natural on your thin frame. I hope that helps! see video

Gregory A. Buford, MD
Denver Plastic Surgeon

Sub-muscular or sub-glandular for a petite woman with low body fat and thin chest wall?

In someone who is thin with little tissue, then I feel that it is even more important to place the prosthesis in a submuscular position. It is almost intuitive that the more covering to the prosthesis you have, the less chance for visualization, rippling and palpation. I have not performed a total subglandular augmentation in over a decade, and in the appropriate case, find the *biplanar* approach far more satisfactory in giving a natural appearing superior slope to the breast than a... more

William F. DeLuca Jr, MD
Albany Plastic Surgeon

www.delucaplasticsurgery.com

Should Petite Woman Go Sub Glandular or Sub Muscular?

!2 answers 11 for sub muscular, one against. You do the math! But in person evaluation can change everything. Best from MIAMI DR. Darryl J. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon

In most patients, below muscle placement is ideal for breast implants.

In most patients, submuscular placement is best. This gives the most natural appearance and the implant is less visible. This is even more important in the slim patient. There are some situations where above muscle placement is better - competetive body builders or professional athletes. Obviously you news to discuss this with your surgeon because there are other considerations, but I suspect a submuscular silicone implant would be best bases on your brief description. You are correct... more

Matthew Schulman, MD
New York Plastic Surgeon

Submuscular Implants Generally More Natural

I definitely feel that implants placed below the muscle have a more natural appearance. This is especially the case in a petite patient who has little breast tissue and a thin layer of subcutaneous fat. I also feel that you will be happier with silicone than with saline.

John Whitt, MD
Louisville Plastic Surgeon

Sub-glandular breast implants

Although there are many advantages of both approaches, I prefer sub-glandular Implants iN someone like you. When done correctly, they give a more natural result, especially with use of the arms. There is no difference in mammographic interpretation. After a few years, there is no difference in most other factors such as palpability and Rippling. Pick the surgeon you feel the most comfortable with.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Submuscular is better than subglandular for implants

In my opinion, submuscular is virtually always better especially if you are a thin person. I can understand your doctor's point but I would still go under the muscle as there are no disadvantages to it and you get more coverage of the implant and perhaps less capsular contracture.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast augmentation

With your frame and weight in mind, my suggestion is to go with the submuscular placement. It will be more natural in appearance, in my opinion/experience.

Shahin Javaheri, MD
San Francisco Plastic Surgeon

Breast augmentation

Petite isn't the issue. The primary determination is patient preference and the quality of your breast skin (thickness, droopiness,elasticity)

Jack Peterson, MD
Topeka Plastic Surgeon

Position of breast implants

There is no easy answer because there are different and possibly conflicting factors and effects: safety, rippling, naturalness, risk of contracture, easy of mammogram. You have to prioritize these factors.and decide which are important to you.

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

Submuscular or Subglandular

In almost all cases, I recommend submuscular silicone implants. I feel that this gives the most natural result and allows for more of your own tissue to surround the implant. However, the surgical technique must be individualized to each patient. Height of the patient really does not factor into the choice of submuscular versus subglandular. Good luck.

David Shafer, MD
New York Plastic Surgeon

Implant position

I usually place implants in a partial submuscular pocket ( dual plane) to give more coverage superiorly. This may help with avoiding rippling, and make mammograms a bit easier to evaluate. As for capsule formation I think it is equivocal.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast augmentation implant position

Generally, most women fair better with the implant placed beneath the muscle. The implants are less palpable. They are in a separate plane from the breast for mammograms. They also tend to "drop" less over the years. There are few good indications for subglandular implant placement

David A. Lickstein, MD
Miami Plastic Surgeon

Breast Implants in Front of or Behind the Muscle?

There are more advantages to placing implants behind the muscle for most women. For thin women a better upper pole shape is obtained. For all women, mammography is enhanced by placing the implants behind the muscle. The main advantages to going in front of the muscle are better lower pole filling for saggy breasts and less movement of the implants with muscle contraction. The later is important for women in competition body building. More advantages and disadvantages can be found at... more