Can I achieve a good, natural-looking result with subglandular implants?

I'm 5'7" and 135 pounds (BMI is 21.1). I am fit but not especially muscular (I have fat). My ribs are not easily visible on my chest (below collar bone/above-between breasts) but are easily palpable. I consistently wear a 34B. Midway between the tops of my shoulders and my nipples, I have over 1 inch of "tissue pinch" above each breast. I desire subglandular implants, about 350 cc. I want to look natural, but looking a little "questionable" isn't a big deal to me. Palpability is not an issue.

Doctor Answers 13

Natural Looking Breast Implants

Natural looking implants depend on the placement of the implant (subglandular or submuscular, but also the placement of the implant on the chest wall, and the size, shape and material of the implant. Another consideration is natural-feeling breast implants, not just natural looking.  It is certainly possible that you could achieve a natural looking result with the right size and shaped breast implant with subglandular placement.  I do wonder why you have decided this is the placement you desire. It may be possible that you have been misinformed about pain, recovery, scarring, or even mammograms.

My suggestion is to find plastic surgeons who provide natural looking results.  When you find a plastic surgeon you trust, discuss your reason for wanting subglandular placement. 

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 120 reviews

Natural Subglandular Implants

It is certainly possible to get natural looking breasts with implants that are subglandular. Even with pictures it would be difficult to give you accurate advice over the internet. There are many factors that enter the choice of where the implant is located and they can best be evaluated by an in person consultation and examination. You should see a local plastic surgeon who is board certified in plastic surgery who will be able to inform you better than we can. Good luck to you.

Margaret Skiles, MD (retired)
Sacramento Plastic Surgeon
3.6 out of 5 stars 13 reviews


Thank you for the question.

To best help you, a physical examination or picture evaluation is required in order to determine which procedure or technique would be best for our case.

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 253 reviews

Natural breast augmentation

A natural breast augmentation is one of the more common consultations I see.  It sounds like you have enough tissue to safely place the implant in the subglandular plane, which will result in a very natural appearance given the right implant is picked for you.  The other alternative is to use a shaped, or anatomic, breast implant.  These result in an incredibly natural look with a nice tapered upper slope to the breast, and a full rounded convexity to the bottom portion of the breast.  The benefit of these implants is that they will give you the most natural look possible, and you keep the benefits of placing the implant under the muscle, namely, lower risk of capsular contracture and visible rippling.

Kyle Song, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 38 reviews

Suglandular implants can result in the most natural result for many patients.

In our practice, we place breast implants above and below the muscle, depending on several factors, some of which you describe.  I am impressed that you have done your research!  There are several caveats I would like to point out - First, we have found it to be important to place textured implants if we are going to place implants above the muscle - this has resulted in our practice in an even capsular contracture rate between subglandular and submuscular implants in the last five years and 2000 implants.  We also want to make sure that your understanding of natural corresponds to the result you are likely to get - this is best done in person, but in general we are trying to find out how much upper pole fullness you desire, because this is difficult to maintain long term in most patients with a subglandular implant. 

W. Tracy Hankins, MD
Henderson Plastic Surgeon
4.9 out of 5 stars 299 reviews

Subglandular implants

Subglandular is one way to go with implants. I prefer submuscular for most people.  Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Options for natural breast augmentation

Hi. There are many choices to make with breast augmenation, most of which have advantages and disadvantages. In terms of position if you have a pinch thickness of 1 inch on your upper chest wall then you should achieve a natural result with subglandular implants.

The size of the implant depends on what size you want to be after the operation, and if you chose an implant larger than your current breast there is a greater likelihood you will be able to see and feel the implants. If you chose large implants >350-400cc then you will achieve a more natural result with shaped (tear-drop) implants compared to round implants. It comes down to what shape/look you want from the operation. The best things is to ask your surgeon to show you photos with similar body frame and similar size implants to the ones you are thinking of to get a realisitic idea of what to expect.

Try to find someone with a Vectra 3D imaging machine in your area to simulate your breast augmenation result (see the link below) - in a recent article (Oct 2013) of Plastic& Reconstructive Surgery Journal (Plast. Reconstr. Surg.132: 810, 2013.), the main Plastic Surgery Journal worldwide, the 3D imaging VECTRA machine was found to be beneficial for patients considering breast augmentation surgery.

The article concluded that patients prefer a center that offers three-dimensional imaging technology; they feel that the simulation is very accurate and helps them greatly in choosing the implant; and that if they could go back in time, they would choose the same implant again.

All the best with your decision. Regards Dr Charles Cope

Charles Cope, MD
Sydney Plastic Surgeon
5.0 out of 5 stars 4 reviews

Natural-looking results with subglandular implants

From your description, I believe you could achieve a natural looking breast augmentation with subglandular implants.  I would probably suggest you consider form stable silicone implants.  This type of implant will result in a more natural "feel" and have a reduced risk of showing implants ripples.  Best wishes.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.8 out of 5 stars 56 reviews

Can I achieve a good, natural-looking result with subglandular implants?

     In general, I place the implants under the muscle as there is more camouflage and a more natural transition.  In addition, most patients undergoing breast augmentation do not have a great deal of tissue.  Thus, there is the need for an implant.  There are a few who may be candidates for this procedure, but an exam would be necessary for evaluation.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Natural look with submammary implants.

Consultation with an experienced board certified plastic surgeon is going to best answer this question.  i generally strongly recommend submuscular placement because implants typically look and feel more natural and are less likely to firm up.  If you have reasons to go on top of the muscle the result can depend on the thickness of your breast tissue.  I would give some consideration to a teardrop shaped implant with highly cohesive gel to help mitigate any upper pole bump and make rippling less likely.  I would avoid saline for you. 

Terrence Murphy, MD
Englewood Plastic Surgeon
4.8 out of 5 stars 28 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.