Is subglandular an option for my goals?

I desire a very natural looking breast. I want to avoid the vertical scarring of a lollipop, and don't mind a small amount natural sag in the finished product. I was recommended a very small Subglandular silicone implant, however all the after photos I'm finding of this procedure have the "baseball in a tube sock" look. I'm open to a periareolar lift. Is it possible to achieve a natural result this way? I'm 35, 5'3" and 130# Also, can I be directed to some examples of this being executed well?

Doctor Answers 5

Is subglandular an option for my goals?

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Thank you for your question.  You are correct and being concerned about a "ball in a sock" look when he subglandular breast augmentation is performed on a ptotic or sagging breast.  For the best result a combination breast lift with submuscular breast augmentation is usually the best option.  To understand the risks please read the following 


Achieving a natural breast looking breast with augmentation.

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A breast augmentation, with some exceptions, will give you a larger version of the breast you started with.  If you have ptosis of your breasts, you will end up with larger ptotic breasts.  How much ptosis you end up with depends on many factors, including how lax you skin is and how large an implant you choose.  Periareolar lifts can be of some help but there is a reason why you can't find many examples of these being executed well, and it's not because all the great result are being kept hidden.  What would give you a result that would be acceptable to you can only be determined between you and your plastic surgeon after a careful examination of your breast dimensions and skin quality.  Always see a board certified plastic surgeon.  Best wishes.


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For most patients, I prefer to place implants under the muscle to camouflage them better. You would have to be seen in person to decide what is best for you.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant

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Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.   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.   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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

Is subglandular an option

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This is a great question.  If you are considering a breast augmentation it is important to understand fully the trade-offs of different decisions. In a patient whose nipple is close to the fold, I will sometimes recommend a subglandular placement so that the implant drops with the breast.  The breasts do not age as well with a subglandular approach and you will assume a higher risk of capsular contracture.  So generally a subglandular approach is a compromise to avoid a breast lift right now- but you may still need one soon.  The elasticity of your breast tissues and the distance of the nipple to the breast fold on stretch also are a factor- if this distance is more than 9.5-10 cm you are going to need a lift or choose to have a mediocre result.  I have a video that talks about this a little more.  There is no substitute for a consultation with a board certified plastic surgeon- get at least 2 consults and compare what the doctors recommend.  A periareolar lift only gives a little bit of a lift and can actually flatten the breast-good if you have a tuberous breast but boxy if you have a normal breast.  And if the distance from the nipple to breast fold is increased you will need to have some of this skin taken out, ie a T lift.  If the plan you are suggesting will only give a mediocre result then it is better in the long term to have the correct plan and decide if you can accept the necessary scar. 

Jonathan Hall, MD
Boston Plastic Surgeon
4.9 out of 5 stars 39 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.