I'm scheduled to get 600cc implants, but I'm not a candidate for submuscular. Any advice or knowledge on this? (Photo)

Question

My doctor says that I'm not a candidate for submuscular or dual plane like I wished to avoid a lift. I already have my surgery scheduled, and just want nice big breast that don't drop to the floor as a result. I guess my big question is will this procedure of 600cc subglandular implants without a lift lead to devastating saggy results, or will I most likely have nice breast that will hold up nicely for the next decade. Any advice?

Gary M. Horndeski, MD · Answer

Your breasts are too low on the chest wall.  600 cc implants weigh over 1 lb each and simply adding large implants will result in large low breasts.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices and half are removed by 9.5 years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

James H. Rogers, MD · Answer

To accurately answer your question would require an examination. However, your breasts are some what ptotic, or droopy, and may require a lift at some point. Often , large implants are used to avoid performing a lift, however the breasts may feel very heavy and pendulous afterward. Most of those patients will end up requiring a lift at a later date, and many will want smaller implants. I would not recommend subglandular implants, because this disrupts much of the blood supply to the breast tissue, significantly increasing the risks of complications as well as compromising the results if a lift is performed at a later date. I would recommend consultation with several experienced surgeons to discuss your options.

Daniel Barrett, MD · Answer

Dear Considerate4189,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. 
Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

John LoMonaco, MD, FACS · Answer

I would have a hard time recommending any size implant in your breast without a lift.  Your breast fold is pretty long, although your nipple position is just a bit low.  If doing an implant only is the only route you would take, then a dual plane III technique would really be needed to perhaps get some kind of lift.Maybe time to get another opinion ?

Ronald J. Edelson, MD · Answer

There is no question in my mind.  You need a lift or your breasts will never be right.  You should get a lollipop type lift with smaller implants under the muscle.  They heal great and will give you a better shape with minimal scarring.  Be advised however that not all surgeons know how to perform that operation so you may need to get a few opinions.

I'm scheduled to get 600cc implants, but I'm not a candidate for submuscular. Any advice or knowledge on this? (Photo)

Answers (9)

Answer: Breast Lift or Just a Big Implant ?

Answer: Breast Lift or Just a Big Implant ?

Answer: Breast surgery

Answer: Breast surgery

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.

I'm scheduled to get 600cc implants, but I'm not a candidate for submuscular. Any advice or knowledge on this? (Photo)

Answers (9)

Answer: Breast Lift or Just a Big Implant ?

Answer: Breast Lift or Just a Big Implant ?

Answer: Breast surgery

Answer: Breast surgery

Browse related questions

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.