PS suggests subglandular implant, but research tells me dual plane is better? (photos)

Hello, thank you for your question. It really depends on what is your desired look that you discussed with your plastic surgeon. You are correct in saying that below the muscle gives more support, but at the same time you can get a snoopy deformity without getting the lift. So its really what you envision them to look like. Either surgical technique will work work. If you wanted a perkier higher look then thats a lift with sub muscular, if you want less scars no lift , sub G and moderate profile. Bring in wish pics with some one who has similar body and breasts like yours that will be helpful in making your decision.

Thanks for your question! Depending on your goals, I may recommend a breast lift. If you are thinking that you’d like perky breasts with added fullness, that’s the route I would recommend taking. Don’t be afraid to seek a second opinion. Good luck!

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, if interested, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dear aericka54,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The answer to this question is based on the in person consultation. Have your surgeon review the capsular contracture risk numbers with you regarding over versus under or partially under the muscle.

Capsular contracture is still a risk under the muscle and muscle is not actually a power that will prevent the descent of the implant. So I would prefer subglandular placement which gives a better lifting effect, which is needed for your situation.

Most of the implants I place are submuscular. This offers a more natural look, lowers risk of capsular contracture, and the muscle "disguises" a portion of the implant via coverage. Subglandular placement will not replace a lift if a lift is recommended. I encourage you to further discuss your goals and concerns with your surgeon.

There is actually not "right" or "wrong" answer. Both options have their +/-. If you are a candidate for both (pass the pinch test), then you just have to decide which is better for you. Over the muscle allows for the implant to drop with your breast tissue as you age. Over the muscle leads to NO animation deformity. Under the muscle has slight decreased risk of CC and allows for more soft tissue coverage, BUT has an animation deformity and as you age the breast will likely fall down or sag more than the implant leading to a snoopy or waterfall deformity. The truth is, you are probably young enough you will need another surgery in the future anyway since most do within 10 years.

I prefer placing the implants behind the muscle for better upper breast fullness, better coverage over the implant, and better long term support. Placing the implants behind the breast tissue will encourage more sagging of the whole breast over time because of the additional weight. You will need to wear good supporting bras.

While I usually place my implants submuscular, you have some droopiness which I feel sub glandular placement would be a better choice.