Over vs under the muscle with slight sag? (Photos)
Doctor Answers 14
Over vs under the muscle with slight sag?
Thank you for the question and pictures.
There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”. I will try to outline some of the differences here; you may find the attached link helpful as well.
I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.
On the other hand, sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle) that can be seen with breast implants placed in these sub muscular position.
I hope this, and the attached link, helps.
Under the muscle
Hello and thank you for your question. There are several advantages
and disadvantages to over vs under the muscle. Under the muscle has the
advantage of lower capsular contracture rates, less risk of rippling, and
better visualization with future mammograms. Most patients say that under
the muscle also has a more natural look and feel. A dual plane technique can provide added lift for you. The size, shape,
and profile of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality.
This decision should be based on a detailed discussion with
equal input from both you and your surgeon. This entire surgery can be performed with a
small incision technique. Make sure you specifically look at before
and after pictures of real patients who have had this surgery performed by your
surgeon and evaluate their results. The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Over vs. Under the muscle
I highly suggest you have breast implants placed over the muscle. This will do a better job filling up the breast skin and will address the sagging. It is certainly possible for you to just get implants without a lift. In fact, I suggest you do that if you are terrified about the scars from a breast lift. You can always make the decision if you want more lift after the implants. The key thing is to have the implants placed on top of the muscle to give maximum lift as opposed to being blunted when placed under the muscle. Implants under the muscle will necessitate a lift.
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Over or under the muscle breast augmentation
An direct examination is necessary to be sure, but I would recommend based on your photos that you place the implants under the muscle with a periareolar lift. I believe that implants stay softer longer, and look more natural under the additional padding of the muscle, assist with evaluation of the breast tissue with mammograms. For that reason, you will not get the same amount of lift as over the muscle, and would benefit from a small lift.
Unfortunately, there is no perfect answer, and you will get multiple opinions. But most surgeons prefer under the muscle. Good luck.
Sorry to confuse you.
Yes, under muscle with ptosis causes snoop dog effect.
An implant with enough projection should give you a nice result without a lift, as long as the implant is ON Top of the muscle.
Over vs under the muscle with slight sag?
Thank you for your excellent question and photographs. I would recommend placement of implants underneath the muscle based on your desired goal appearance stated in your narrative as well as it affords a more natural appearance, greater implant coverage, and trends towards fewer complications. Hope that this helps.
Over vs under the muscle breast implants with slight sag?
Thank you for your question photograph:
- In my opinion there are many advantages to having the breast implant placed underneath the chest muscle which will go a long way to avoiding the ball and socket appearance
- Your nipple appears to be above the inframammary crease or the fold under your breast. Based on this a dual plane submuscular breast augmentation should give you a nice result.
- Having the dual plane breast augmentation will avoid the scars associated with a breast lift.
- The implants will project the breast forward and you may not need a lift in the future since you're done having children.
- If eventually you decide to want a lift it can be done as a second procedure which is the way combination lift and augmentations were done satisfactorily for many many years.
- For more information please read the link below:
I prefer in most cases to place implants under the muscle. It does not look like you have any significant ptosis on your lateral views.
Go for the long-term fix
For the best long-term result, put the implant under the muscle. The complication profile between submuscular and subglandular implants is TOTALLY different. An implant under the muscle reduces the risk of capsular contracture, makes the implant less visible and less palpable, and weighs less on the skin. Using a "dual plane" technique, you would not need a lift. Yes, you may need one in 10 years, but do your implants correctly now so that doesn't need to be fixed too! Good luck
Is lift necessary?
I do not feel that you need a mastopexy. In terms of implant placement, it is true that placing the implants over the muscle would make for an easier recovery in the short run. However, because you don't have a lot of breast tissue, I would be concerned about rippling and capsular contracture. Silicone or cohesive gel implants will produce a natural result.
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.