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What is the Best Implant Position for Tuberous Breast? (photo)

asked 4 months ago by April Nichole in Charleston, SC
Latest answer by Gary M. Horndeski, MD
Question viewed 222 times
Tags: placement, recommendation, tuberous

I am 27 yrs old & a 36B. I have 1 son who I nursed. I am very athlethic. My PS says that I have tuberous breast & he will have to give me a mastopexy/augmentation. What is the best placement for the implant? Submuscular or subglandular? He says that the subglandular is better considering my constriction but I have heard that submuscular is the placement of choice when it comes to longevity, future ptosis and rippling/contracture. I want to go up to a full C/small D.

12 answers to What is the Best Implant Position for Tuberous Breast? (photo)

Tuberous breast?

Your photographs show breast ptosis NOT tuberous breasts. I routinely place all my implants submusclarly to decrease the risk of capsule contracture and for long term maintenance of position. More important than the implant in your case is the lift. You will need a circumareola approach, which will allow the implants to be placed and lift your breasts at the same time. This can be done avoiding a vertical incision, which is unsightly, or the boat anchor shaped... more

Gary M. Horndeski, MD
Houston Plastic Surgeon

Implants do better above the muscle with tuberous breasts.

It is not easy to tell if you have tuberous breasts, sagging breasts, or both. In any event, you would probably benefit from a breast lift, along with placement of implants. If your breasts are tuberous as well, I feel results are better with implants above the muscle. You may also benefit from a two-stage procedure.

Michael Leff, MD
Bellevue Plastic Surgeon

Tuberous breast?

Just looking at your photos, it does not appear that you have a tuberous breast. I usually place implants under the muscle in patients with little breast tissue. You probably need a lift as well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Tuberous Breast Deformity.......

I have to agree with Dr Hochstein on two counts. 1) It doesn't appear to me that you have a tuberous breast. You definitely have drooping and at most a very mild component of constriction if any at all. 2) I never place implants on top of the muscle any more. I haven't performed Sub Glandular Augmentation in about 10 years. There are so many benefits to Sub Muscular that it's hard to justify doing subglandular implants at all. ... more

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

DiscoverTheBeauty.com

Tuberous?

I do not see a tuberous breast but rather a ptotic(droopy) one. I agree that you will require a lift to achieve optimal results however I do not believe that a breast implant should ever be placed above the muscle. The risk for long term problems with this method is much greater and I do not believe surgeons who specialize in augmentations would do that. Insist on going submuscular.

Leonard Hochstein, MD
Miami Plastic Surgeon

Implant pocket

Hi there- as your surgeon is the only one who has actually examined you and best understands your goals and examination, I would trust his advice. Generally speaking, I would say that the longevity and risk profile of implants placed at least partially under the chest muscle is better over the long term for the majority of patients. Even when a short term aesthetic benefit exists for placement over the muscle, I think this is outweighed by the longer term risks. Discuss this... more

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Implant selection

It is difficult to tell from your photos if you actually have tuberous breasts. It appears that you have a good deal of breast sagging since the position of your nipple is well below the inframammary crease. There are many possibilities for achieving a nice result. There are pros and cons to every surgery. It will only be possible to understand your options after a consultation. At time the degree of your breast sagging as well as the quality of your soft... more

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Tuberous breast correction and implant placement

Thank you for the photos. Since you have partial views of your breasts in the photos, it is hard for me to appreciate if your breasts are tuberous. I see that you have significant sagging and large nipple-areolar complexes. I, personally would do a short scar breast lift first, which would reshape your breasts, give you more projection, reposition the nipple-areolar complex and also make it smaller in diameter. I would do an augmentation at a later date after you are healed from the lift and... more

George Marosan, MD
Bellevue Plastic Surgeon

Subglandular vs. Subpectoral placement for tuberous breasts?

The constricted or tuberous breast has a tight, constricted lower pole. These constricting bands need to be released and the implant needs to be allowed to stretch and fill out and round out this lower pole. Although it is true that an implant in a subglandular plane will do this effectively, in my opinion an implant in a subpectoral plane will also do this equally well AS LONG AS a dual plane technique is used to release the pectorals muscle from the overlying breast tissue to... more

Robert M. Grenley, MD
Seattle Plastic Surgeon

Tuberous Breast and Implant Positioning?

Thank you for the question and pictures. Yes, you will benefit from breast authentication/mastopexy surgery. In my opinion, your understanding of the benefits of the sub muscular (dual plane) positioning of breast implants is correct; if you were my patient this is the approach I would use ( whether there is breast constriction or not). However, you will find that there will be different opinions on how to achieve the best results with your planned procedure.... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Correction of Sagging and Tuberous Breasts

You want a simple answer where one does not exist. Tuberous breasts appear the way they do because they breasts are constricted, they cannot expand and assume the round attractive shape of a mature female breast. To achieve that shape requires BOTH releasing the constricting fibers within the breast AND using a breast implant under the breast to prop and keep the released breast open. Similar, if you will, to the way a lawn umbrella is opened and then can be held opened by propping a large... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Best implant position for tuberous breast

You have a difficult decision because you are trying to fix and be concerned about many things. Although the submuscular placement yields some benefits, the subglandular position is better for a tuberous breast. Also, I am not sure that a D cup with a submuscular implant will be possible and at the same time give you a good resolution of the tuberous breast issue. You might need to divide the procedures up, correcting the tuberous breast first and then going to the next phase. more