I am due to get 200cc teardrop subglandular implants in 3 weeks and I am having a lots of concerns? (Photo)

My surgeon suggested subglangular as I do a lot of exercise and weights. I want a very natural look and feel and I'm worried that my lack of breast tissue will mean you will feel the implant. Also will teardrop give me the most natural shape?

Doctor Answers 11

Upcoming breast augmentation

Hello and thank you for your question. Implant placement can be a significant factor in the appearance of your breasts after augmentation. I prefer submuscular placement, as it reduces the appearance of rippling of the implant. If you are concerned about be able to workout your upper body. I suggest modifying your workout for a short period of time to allow the implants to settle into the correct position.  Then you can resume your normal activity once this has happened. I also use a smooth round implant for most of my patients and still achieve natural looking results. I suggest discussing your concerns with your surgeon to help clarify some of the questions that you may have. Good luck with your upcoming surgery. 


Philadelphia Plastic Surgeon
5.0 out of 5 stars 7 reviews

Second thoughts

Get another opinion. I like putting them subglandular , but I think that the round silicone implants work the best. If teardrop implants shift they look terrible. Round silicone are the softest most natural.. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

Implant selection

My preference is to place them under the muscle.  This will provide more soft tissue coverage. Best to be evaluated in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

I am due to get 200cc teardrop subglandular implants in 3 weeks and I am having a lots of concerns?

You have excellent breast anatomy and should be able to achieve a nice result after breast augmentation.

In my experience a properly done breast augmentation under the muscle does not interfere with weight lifting and exercise.

York right to be concerned that textured implants under your small breasts on top of the muscle would have many disadvantages namely visibility of the implant, and palpability of the implant as the textured implants are much thicker walled.

A recent survey of experienced, board certified, cosmetic plastic surgeons revealed that 83% of these surgeons  used smooth  round silicone gel implants.  There are many advantages to placing the implant under the muscle.

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape 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.  This entire surgery can be performed with a small incision technique.  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.  
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 80 reviews

Right implant? What matters are your dimensions, the fill, and your soft tissue coverage

There are a lot of great implants are the market today, and there is no one exact right implant for every patient. What does matter is the following: does the implant fit your base width-an oversized implant can damage the soft tissues, produce more visibility, and is more likely to bottom out over time. Next, what is the implant filled with? A softer round gel implant may give you some volume, but it will not produce shape to the breast. The softer gels, like Inspira, are better for adding volume; shaped highly cohesive gels are probably best for creating shape and correcting asymmetries. Finally, what is your soft tissue coverage- this means do you have enough breast and fatty tissue to cover the breast implant edges and not see or feel the implant. If you are very thin, an implant that is subglandular may be more visible and palpable, if you have a little more coverage, the implant can be placed subglandular without these issues. 

Bottom line, every implant has its pluses and minuses, if you are concerned about your level of activity, go with a subglandular implant, but be aware of the trade-offs of potential visibilty and palpability of the implant under your thin soft tissue. You need to decide what is best for your look and your life-style. Best of luck.

Caroline Glicksman, MD
Sea Girt Plastic Surgeon
4.6 out of 5 stars 10 reviews

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon

Lots of concerns about breast implants?

Thank you for the question.  Based on your photograph, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.



Generally speaking, anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. ***Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.



 I think it is in the best interests of most patients (including athletes) seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 


On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.  



Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.  If still in doubt, seek second opinion consultations with well experienced board-certified plastic surgeons in your area.


 

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:



1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.



2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.



3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.


I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

The right implant for you?

It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

Dual Plane

Hello. Thank your for your question in regard breast augmentation.

It is important when considering a breast augmentation to have a clear communication with your plastic surgeon in regarding your goals.  There is a combination of methods that use as surgeons tried to which desired look.  Some of these methods include plead examination, breast diameter measurements and nipple to inframammary fold measurements, the dimensional computer systems and implant sizers.

Your PS should have discussed the pros and cons of the different implants. There are many sizes that would look great on you and you should work closely with your PS to find the ideal size.

In your specific case I WOULD FAVOR a dual plane method. It is obvious based on this forum that plastic surgeons will have different answers for you. It is important that you discuss the pros and cons with your plastic surgeon to determine the best position.

The incisions of the Dual Plane breast augmentation surgery include:

Decrease Risk of Capsular Contracture- due to the submuscular position of the implants

More natural appearance

Once small, inconspicuous exterior incision

More natural movement as you walk.

Best of luck with your surgery !

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.