What Are the Pro's and Con's of Implant Placed in Front or Behind Chest Muscle?

I've had silicone implants since 1978. They maintained a natural feel all these years. They've started to leak, One has started to contract and has become hard.I have had consultations with two doctoc's. They have each given me a different replacement proceedure. One, to use a Sientra tear-drop implant along with a breast lift. The other doctor would use the Mentor MemoryGel silicone gel implant, placing it under the chest wall muscle, plus a breast lift. I'm confused as to what to do.

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9 Doctor Answers | Asked by Carol in CA

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What are the advantages of going above vs below muscle in breast augmentation?

When deciding between above and below muscle implant placement, consider the following Below Muscle: more natural/smoother teardrop shape as the muscle covers the upper part of the implant, muscle provide additional layer of coverage over upper breast implant hiding the outlines and rippling of the implant, and going under has a slightly lower risk of implant hardening/capsular contracture. The downside of going under the muscle is that when you flex your muscles, the implants get... more

What Are the Pro's and Con's of Implant Placed in Front or Behind Chest Muscle

Sub-muscular placement is usually not totally submuscular The muscle is usually incised inferiorly to create more space The muscle invariably retracts upwards resulting in the lower third of the implant to be in the subcutaneous position Muscle contraction causes compression of the implant and may cause distortion The muscle does cover the upper pole more effectively,and may be of some benefit in terms of mammography Placement of the implant above the muscle is... more

Sub Muscular vs. Sub Glandular Implants - Which Is Best For Me?

Thank you for this challenging question. I am going to have to make certain assumptions. First, since your surgery was done with silicone implants in 1978, I will pretty much bet they were on top the muscle at that time. One implant now has a capsular contracture, therefore, that pocket has been compromised. Fortunately, it is probably above the muscle, and you want to go sub muscular anyway to decrease the chance of capsular contracture. The plastic surgeon... more

Sub muscular versus Sub Glandular Breast Implant Position?

Thank you for the question. Based on the details in your question, I would not be surprised if you are presenting with a complicated situation in regards to your breasts. Keep in mind, that I cannot provide you with precise advice without direct examination and a full communication of your goals (which I would be happy to do). However, some general thoughts about breast augmentation done in the sub muscular versus sub glandular position may be helpful to you. There are pros and... more

Above or below the muscle?

Breast implants: “Over or Under?” What about both? Simply put, if you are considering breast augmentation, it is likely that you want more beautiful breasts. My goal is to achieve the most natural and beautiful breast augmentations that I can. How I achieve that depends upon my skill, experience and judgment. One of the most important considerations when planning a breast augmentation operation is how I will place the implants with respect to the... more

Sub muscular conversion of breast implants

In the face of capsular contracture above the muscle it is common to consider sun muscular replacement plus a lift if indicated. Unders are felt to give better mammograms, have less scar tissue, and hold up better long term.

Seek A Third Opinion

Since you have 2 divergent opinions and have not provided photos, I would suggest a third opinion. I do not like tear-drop implants and almost always place implants below the muscle, but again would like more information to give a definitive answer.

Breast implant positioning

There is no single best way to achieve a desired result, but each surgeon has a preferred approach. Our website explains advantages, disadvantages, and elements to consider when deciding upon implant positioning.

Breast surgery options

There are many different ways top "skin a cat." So, when you go to different doctors they will often offer different options and solutions. There are many different reasons for implants below or above the muscle.