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Sagging Breast w/ Skin Tissue and Volume Loss - Submuscular or Subglandular Gel Implants w/ Lift?

asked 1 year ago by Plgibson in Vancouver
Latest answer by Tom J. Pousti, MD
Question viewed 2,558 times
Tags: age 35-44, 150-169 lbs, 5 ft 0 in to 5 ft 3 in, sagging, C cup, comparison, subglandular, submuscular

confused on if I should get subglandular gel implant with my lift which my ps is recommending or ask for submuscular. I am 42 lost 80# in the last two years now through healthy diet and exercise I am now 5'3and 155# 34C sagging breasts extra skin loss volume. I want to be a full D or DD again and high and tight. I thought under the muscle would be better? Even though it sounds more painful. I'm worried about capsular contraction Gettingtummy tuck too March 14th. Any advice

12 answers to Sagging Breast w/ Skin Tissue and Volume Loss - Submuscular or Subglandular Gel Implants w/ Lift?

Breast Implant Positioning?

Thank you for the question. In general, 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... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Submusclular Implants

I would recommend a submuscular implant with a full mastopexy/lift. This technique is the the most widely used and will give you the most coverage of the implant with the least complications. I think a tummy tuck will also do wonderful for you. Good luck. Kindest regards, Neil J. Zemmel

Neil J. Zemmel, MD
Richmond Plastic Surgeon

Breast lift with Implant

There are several good reasons to have the implants placed below the muscle which is my preference. 1. Less likely to see rippling in the upper pole of the breast where most women have lost volume from either weight loss or having been pregnant. 2. Better visibility of the breast during mammograms. 3. Diminished capsular contracture rates. I too would caution with having too large of an implant placed. The skin of patients who have lost a... more

Brian Joseph, MD
Orlando Plastic Surgeon

I prefer the submuscular approach.

I prefer the submuscular approach. I have found that the submuscular location results in: 1)more tissue covering the implant for a more natural look 2) improved mammograms when compared to the subglandular implants and 3) decreased rate of capsular contracture. see video

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Over or Under the Muscle with Breast Augmentation and Lift

I would recommend a submuscular placement for several reasons. 1) If you are having a lift at the same time there is less disruption of the blood supply by going under the muscle. 2) The incidence of capsular contracture is less. 3) You will have a higher chance of rippling down the line with a subglandular implant. That being said, I would caution you about your expectations as far as "high and tight". Typically women with massive weight loss tend to have thin... more

Babak Dadvand, MD
Los Angeles Plastic Surgeon

Lift and augmentation later under the muscle would be the best and safest way

The combination of the mastopexy and augmentation has a high dissatisfaction rate due to the complexity of the combined procedure. The safest thing is to do the lift and augmentation later. If you decide on the combined procedure,submuscular placement is safest due to the preservation of the blood flow to the nipple.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Submuscular Implants Generally Have Lower Capsular Contracture Rate

Congratulations on your weight loss! I feel that implants placed submuscularly have a lower rate of capsular contracture. Since this seems to be an important consideration for you, you might ask your plastic surgeon his/her reasons for suggesting a subglandular placement.

John Whitt, MD
Louisville Plastic Surgeon

Breast lift/augmentation and a tummy tuck

You will do well with a tummy tuck. Your breasts are harder to get a high, full and tight look because of the poor elasticity of your tissues. I'd advise a submuscular approach with a full lift. The large size you want maybe can't be safely done that same day as the lift though because the lift tightens you and the big implant stretches you.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast Lift and Implant Position

I would recommend a submuscular placement as well. Given your breast size and shape a subglandular approach is unlikely to give you the fullness in the upper part of your breast that you are looking for long term. Keep in mind that the larger the breast, the more sagging that will occur over time. Therefore, the larger the implant, the more likely you are to need another lift in the future.

Derek Lou, MD
Houston Plastic Surgeon

Mommy makeover - tummy tuck and breast lift/breast implants

You have answere your own question to some degree in that you want to be high, tight and full in the breast area. That will require a skin procedure in addition to an augmentation. The question is which skin excision pattern to use and you should choose that after being informed of the pros and cons of each pattern in your case. Do yourself a favor and do not go to a DD size. Larger implants only increase the risk of recurrent drooping/sagging of the breasts. The good thing is the... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast lift and augmentation combinations work well

You need both a breast lift and an augmentation. One could debate the pros and cons of implant placement- but in my practice, we would offer a vertical breast lift in combo with a small submuscular silicone implant. You have plenty of your own breast tissue, and would likely have a nice result with breast lift alone.

Scott Sattler, MD
Bellevue Plastic Surgeon

Implant position

My preference for patients that do not have a lot of breast tissue is to place the breast implants in a dual plane ( submuscular upper pole) approach.