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Should I Go Submuscular or Subglandular?

asked 9 months ago by leanneg in Staines middlesex
Latest answer by Andrew P. Giacobbe, MD
Question viewed 943 times
Tags: age 18-24, 130-149 lbs, 5 ft 4 in to 5 ft 7 in, comparison, options, recommendation

I am 21 and going to be having a breast augmentation in october. I have seen two different surgeons who have both told me different things. im 5'5 and 140lbs im a very small 32D and lack fullness. Im very small up top with a large bottom half and want to be in proportion. The surgeon has recommended 380cc, Should i go submuscular or subglandular?

16 answers to Should I Go Submuscular or Subglandular?

Submuscular or subglandular breast augmentation

Breast implants may be placed in either a submuscular (under the pectoral muscle) or in a subglandular (above the pectoral muscle) pocket. An important factor to consider when determining implant location is the amount of breast tissue present above the muscle. Most augmentation patients tend to be slim females with minimal breast tissue, and in these patients submuscular augmentation provides the best result. In patients who have a moderate amount of breast tissue over the... more

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon

Submuscular better than subglandular

There are numerous advantages to submuscular implants. These include less capsular contracture, less rippling of the implants, more natural feel, less palpable implants, less problems with a lift in the future, less sagging over time and they get in the way less when performing a mammogram. On top of the muscle hurts a little less when they are put in. Most surgeons now put the majority of their implants under the muscle.

James McMahan, MD
Columbus Plastic Surgeon

Breast implant placement and sizing

Submuscular. It is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore,... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Submuscular or subglandular?

I think that most plastic surgeons prefer to place implants in the submuscular position these days if you are a good candidate. My reasons for doing so are threefold: 1. With saline implants, the extra layer of coverage (the chest muscle) over the implant may help minimize the risk of ripples/wrinkles that can possibly be felt or even seen. 2. The continuous motion of the chest muscle over the implants as you go about your daily routine massages the implants and... more

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon

Should I Go Submuscular or Subglandular?

Seems the majority of previous expert posters chose sub muscular placement. As do I. So I hope that answers your question.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Under the muscle is better

There are pros and cons of every decision. Under the muscle has less chance of hardness (capsular contracture), as well as less chance of obscuring findings on mammogram. It also has less chance of having problems with breast feeding and less chance of making your breast sag (as there is less "weight on the slinky"effect). The only thing better is that there is less chance of movement of the implant with flexing. I would encourage big time going under... more

Dan Mills, MD
Orange County Plastic Surgeon

www.danmillsmd.com

Either way can give good results

I perform breast augmentation both above and below the muscle and have had good results with both. I have also had some capsular contractures with both. As a general rule, with saline implants I would prefer to place them under the muscle. There is less likelihood of capsular formation and wrinkling and rippling that is more palpable above the muscle. With silicone implants, I think either way will work well. But for very thin individuals who do not have much... more

James Tang, MD
Houston Plastic Surgeon

Breast Implant Placement

Hello Leanneg, There are surgeons that still routinely place implants over the muscle, however, scientific evidence suggests better performance and lower risk of early and late complications with submuscular placement of implants. Additionally, I would stay conservative with implant size (380 cc is probably fine), and choose a moderate profile implant. High profile implants do not perform well over time and are likely to cause unpredictable tissue stretch and tissue... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

Subglandular vs Submuscular

Submuscular has the advantage of having more tissue to cover the implants. Submuscular usually results shorter recovery

Tony H. Pham, MD
San Jose Plastic Surgeon

Breast implant placement above or below the chest muscle

There are many advantages of having your breast implants placed subpectoral, instead of subglandular (in front of the muscle). In the subpectoral position there is less risk of capsular contracture, more natural breast contour, higher likelihood of breast feeding and easier interpretation of mammograms. There is less pain associated with subglandular breast implant insertion, but that may be the only advantage. Discuss this in further detail with your plastic surgeon before surgery. Best... more

William Bruno, MD
Beverly Hills Plastic Surgeon

Submuscular or subglandular.

Look at photos on line, and try to decide which you like better. implants beneath the muscle or over them. look for size you like on a patient that starts with about your volume.

Rick Rosen, MD
Norwalk Plastic Surgeon

Sub-muscluar or Sub-glangular Breast Implant

You will find opinions on both sides of this question but most surgeons prefer sub-muscular placement and I include myself in that group for the following reasons: You will have more fullness of the upper breast. The lower portion of the breast will have more support and there will be less sagging over time. Some day you will need a mammagram and it is technically easier to X-ray the breast when there is a layer of muscle separating the breast from the implant. Some... more

Joseph Fata, M.D.
Indianapolis Plastic Surgeon

www.breastsurgeryindianapolis.com

Sub-muscular or sub-glandular

There are a lot of considerations and style issues that can be considered with this discussion but the most important consideration is what happens in the long term. You can get a nice look and easy recovery with an above muscle implant but in the long term, the tissue over the implant thins and stretches. I do not place very many implants above the muscle but I sure do a lot of correction of above muscle implants that have now thinned and stretched the skin. ... more

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Going above or below the muscle

At 5'5" and 140lb you most likely have enough fat under your skin that it would cover the implant, thus you have the option of either above or below the muscle. Below the muscle gives you a nicer slope to your breasts and lowers the risk of implant hardening (capsular contracture). Going above the muscle gives you rounder / faker look that some women may want. You mentioned you are D cup... you look like A cup... I suspect you mean you want to go to D cup.... more

Martin Jugenburg, MD
Toronto Plastic Surgeon

www.torontosurgery.ca

Over or under

It's hard to make any recommendation to you without seeing a photo of you undressed (no face please). You look like someone who is small and young without kids so you likely don't have a 'drooping' issue...again, these are assumptions. Given what I imagine you look like I'd prefer to see you with under muscle placement- unless your exam shows me something I'm not expecting.

Scott E. Newman, MD
New York Plastic Surgeon

www.psurgery.com

Submuscular vs Subglandular

I would probable recommend a high profile implant- either saline or silicone- because you could get a little more projection with a smaller diameter device. I would also recommend placing it submuscular; I believe this so-called "dual plane" approach would accomadate this implant a little better, and may better address concerns regarding "capsular contracture" . I would discuss this thoroughly with your plastic surgeon, and get another opinion if needed. Best... more