Would over or under the muscle be the best option for tuberous breast? (Photo)

Would over or under the muscle be the best option?I am getting a breast augmentation with a lift only around the nipple because I have tuberous breast. My doctor recommended memory shape implants over the muscle. Do you agree over the muscle is the best option?

Doctor Answers 6

Over or Under

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
 In your situation, if properly done, a dual plane approach would have the advantage of sub muscular coverage on the inside and on the top but also allow for the scoring and stretching of the bottom portion of your breast. In my opinion, there's no reason to put these implants below the gland where they can be more visualized, have a higher Contracture Rate, and may have decreased visibility of breast tissue on mammography. The other part of the plan with the gel implant in a purse string mastopexy I would agree with. Good luck.

Louisville Plastic Surgeon
4.7 out of 5 stars 56 reviews

A shaped cohesive device is the right implant

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Generally speaking, cosmetic breast surgery to correct tuberous breast consists of three things:

1. Implant placement
2. Scoring of tight, constricting lower pole
3. Circum-areolar mastopexy/nipple-areolar reduction

The shaped cohesive devices are great for this surgery and help stretch out the lower pole that is causing some of the problem.  I place these the vast majority of the time under the muscle though.  The area in the lower pole that needs to be stretched out has no muscle overlying the implant anyway, so really the advantages are more soft tissue coverage in the upper pole and lower capsular contracture rate in the future.  Hope this helps.


Would over or under the muscle be the best option for tuberous breast?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift, hugs!! 

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 437 reviews

Implant and tuberous

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I prefer in most cases to place them under the muscle, especially in patients without a lot of soft tissue coverage.

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

Finding the right surgeon

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Sub muscular or sub pectoral placement may be more uncomfortable the first few days following surgery due to the disruption of the muscle. The possible benefits of submuscular placement are that it may result in less palpable implants, decreased risk of capsular contracture, and easier to image the breast with a mammogram. Under the muscle placement is recommend for women are are very thin with very little breast tissue. The partial muscle coverage will hide the implant better and help avoid visibility of any implant imperfections such as rippling. The appearance will also look more natural.

Over the Muscle (sub-glandular) – Over the muscle means above the muscle and under the breast tissue. This placement may make your surgery and recovery shorter and you will likely have less discomfort. This placement can provide a slight “lift.” Sub-glandular placement can result in more palpable implants, increased risk of capsular contracture and more difficult imaging of the breast with mammogram. This placement is often recommended for those patients with mild breast sag, but do not want a breast lift (mastopexy) and for tubular breast deformity.

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a breast augmentation.

Would over or under the muscle be the best option for tuberous breast?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
In order to achieve the best looking breasts in your case you'll need an  anchor lift/mastopexy, and correction of the asymmetry preferably with a mild reduction of the larger side and same size implants placed under the muscle.Hope this helps

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.