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

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.

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

     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, MDLos Angeles, CA

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

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. 

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. 

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

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. 

Hello, thank you for your question. I personally don't like sub glandular implants, because, even if they look fine at first they will always, in time develop that round curve that basically paints your implant on your upper chest. The coverage provided by the muscle will always aid you to have a full cleavage with a smooth transition to volume. On top of that, under the muscle implants have a much lower capsular contracture rate. Good luck with your surgery

From your description it appears that you should be able top obtain a satisfactory result with the implants above the muscle. The size of the implant is determined by several other factors, including your expectations, quality of skin, chest shape, and nipple position. There are advantages and disadvantages for both above and below muscle placement, and these should be discussed with your surgeon.