I have been recommended subglandular and submuscular placement at two different consults. I hope to attain a full lower pole, a more centered nipple and cleavage through saline implants since my left breast is smaller than my right. Is saline better for me than silicone? And are my expectations realistic? Would I also need another procedure to release the constricted inferior pole?
With my Anatomy Can I Realistically Achieve a Full Lower Pole with a Centered Nipple?
Doctor Answers 8
Correction of ptotic, constricted breast
Your expectations are realistic. You can obtain a full lower pole and a more centered nipple. Cleavage is determined by your body and can only be enhanced somewhat. From your pictures, I would use sub-glandular implants after releasing the lower pole and deep breast tissue. However, pictures can only go so far. What you need is a consult with a surgeon who does a lot of different shaped breasts. Ask for experience and qualifications before making the appointment. Once you have had the appointment, if what you are told makes sense and he/she seems to have adequate experience and you are comfortable, go with what you are told. You could have many consults with a number of very qualified surgeons, all of which could do a great job, and still get differences of opinion. That does not mean that one is any better than another, just that everyone has a slightly different way of achieving the same thing.
Breast Augmentation / Lower Pole Fullness
I agree with Dr Rand. I think you can obtain a beautiful result with subpectoral implants but you will need a nipple lift. Without the lift (NipplePexy) you will see much of the lower pole of your breast.
Questions regarding the potential postoperative appearance of the breasts
You should be able to obtain a very satisfactory result from breast augmentation surgery but don't expect full symmetry and perfection. Silicone implants would afford you a much better opportunity to obtain the outcome you are seeking. I would also recommend that they are placed behind the muscle versus in front of the muscle.
You best bet would be to seek out a reputable board certified plastic surgeon in your area who performs a lot of breast augmentation procedures.
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Full Lower Pole With Augmentation
I do not feel that you should have a problem achieving the result that you desire (full lower pole, symmetry, etc.) if you are operated on by a qualified and well trained surgeon. Seek a consultation with a board-certified plastic surgeon (preferably one who is a member of the American Society of Aesthetic Plastic Surgeons (ASAPS). It is generally more difficult to achieve upper pole than lower pole fullness. I feel that your minor asymmetry can be adressed with silicone implants which are (I think) always preferable to saline implants.
You asked this same question yesterday when you wondered if you had "severe tuberous breasts." Again, you need a periareolar lift to move the nipples up, a slight lowering of the crease to gain length below the nipple, and an implant placed below the muscle in my opinion. You would look as though you could have a nice result.
Subglandular vs. Submuscular placement of breast implants
I think you can get a very nice result but I don't usually recommend sub-glandular (over the muscle) placement. With a surgeon who has experience, you can achieve a rounded out look with better areola placement. Do your research regarding the surgeon's you visit - make sure to choose a surgeon who is certified by the American Board of Plastic Surgery (not cosmetic surgery) and a member of the American Society of Plastic Surgeons. From here, you know you are selecting from qualified surgeons. Most board certified plastic surgeons would suggest sub-muscular placement for better long term results.
Can I achieve my desired breast augmentation results?
Your expectations are realistic and your desired results attainable. A full consultation and exam are required to make the best recommendation. From your pictures I would recommend a silicone implant over the muscle with a circumareolar lift. It is possible that you may require more than a circumareolar lift, but this can only be determined after examination and discussion of your expectations. Always choose a Board Certified Plastic Surgeon who is a member of the American Society of Plastic Surgery.
Correction of constricted lower pole
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