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Hello, and thank you for your question. The difference might be small as far as size. However the overall appearance can be very different when the placement is suglandular versus submuscular. I would recommend a board certified plastic surgeon with vast experience to design a plan that is tailored specifically to you. Best wishes,Franziska Huettner
Submuscular placement affords placement of smooth implants, less long term rippling, greater camouflage, and probably a reduction in tissue thinning over time. Most patients with small breasts are better served by a submuscular augmentation to permit a more natural breast takeoff and better camouflage for the implant. The compression factor you reference is generally associated with under rather than over the muscle placement, not dual plane. Very few breast augmentation patients have enough breast tissue to permit a subglandular augmentation. Slightly decreased projection may be noted following submuscular placement, but no actual loss of volume.
Thank you for sharing your excellent question. I feel the disparity in your sizes is too large to account for projection differences in a sub glandular and sub muscular implant placement. I would recommend speaking with your surgeon in greater depth regarding your goal results, and what size implant best approaches this.
When undergoing breast augmentation there are a number of choices which need to be made: saline or silicone? Volume: Larger or smaller? Incision? However, one of the most commonly debated choices is that of implants placement: subglandular/ submammary vs. subpectoral/ submuscular? While many surgeons recommend submuscular placement there are distinct differences to each approach. Subglandular Augmentation (“overs”): Subglandular augmentation means place of the implant underneath the breast tissue but above the pectoralis muscle. Subglandular placement spares the pectoralis muscle which leads to reduced post operative pain/discomfort and no impact on muscle function post augmentation. Recovery is also faster.Subglandular augmentation can impact mammographic evaluation of the breast. However, as dedicated breast radiography has become more prevalent this has become less of an issue. Fellowship trained radiologists have become familiar with evaluating breasts post augmentation. It is also important to note that implant position does not interfere with visualization of breast tissue via contrast enhanced MRI (the most sensitive and specific study available for breast cancer detection).Studies suggest there is an increased risk of capsular contracture when implants are placed in a subglandular space.Aesthetically, implants placed superficial to the pectoralis major create a rounded, convex appearing breast profile. This effect is camouflaged, at least initially in larger breasted patients. However, as a woman ages fat atrophies and breast tissue descends. The result is a more noticeable implant specifically in the upper pole. Similarly, patients who have thin coverage superiorly are more likely to be able to perceive the implants and at higher risk of visible rippling when compared to subpectoral augmentation.Subglandular implants can also create the illusion of improved cleavage by preferential over-dissection of the central/medial pocket allowing the implants to be forced more to the midline. There is no limiting muscle as there is in a submuscular augmentation. Subpectoral Augmentation/Sub-muscular/Dual Plane (“unders”): Subpectoral augmentation is technically a bit of a misnomer. Traditionally, subpectoral augmentation involves the release of the pecotralis major muscle from its lower attachments. This allows the muscle to “window-shade.” The upper hemisphere of the implant sits underneath the muscle (dual plane). This release contributes much of the discomfort encountered postoperatively by patients.Subpectoral implants have a lower rate of capsular contracture.Aesthetically, in contrast to submammary implants (which are prominent in the upper pole- especially in thinner patients), the pectoralis muscle both conceals the underlying implant and flattens the upper pole. This flattening effect creates a natural sloping as one proceeds from the upper portion of the implant to the lower portion.The most commonly cited drawback to sub-muscular augmentation is the animation deformity associated with contraction of the overlying muscle.In my practice, the vast majority of patients will have the implants placed submuscular for all the reasons listed above.With regards to your specific question, the difference between an implant placed submuscular and subglandular is one of projection and less of volume. Volume is volume irrespective of location. However, the overlying pressure of the muscle may impact the degree of projection in a given device (greater projection "over" relative to "under"). That being said, I do not think that would account for the large differentials in volume you are considering. While a slight downsize may be in order, I would not suggest an equivalency between a 300 cc implant and an implant half as large.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MDBoard Certified by the American Board of Plastic SurgeryMember: American Society for Aesthetic Plastic Surgery, American Society of Plastic SurgeonsRealSelf Top 100RealSelf Hall of Fame
There is no standard "equivalent" volume difference when comparing breast implants placed in the sub muscular versus sub glandular position. Make sure, as you move forward, that you understand the pros/cons associated with breast implant positioning- you will find a lot of information on the Real self website in this regard.My best advice: more communication.It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further. As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?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, 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 helps. Best wishes for an outcome that you will be very pleased with.
There is a fairly big difference between 300 cc's and 190 cc's. I would suggest meeting with your surgeon and asking to try on sizes. There is a more true size with just placing the sizers in your bra and the subglandular position, than with the subpectoral position. But, the subpectoral position gives more upper breast fullness than you may not have with the subglandular position. The volume is the same, but the look does vary.
Hello. Thank you for your inquiry. It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results.During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.We encourage you to look at our website and Instagram (drkaraplasticsurgery) for lots of before and after pictures!Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mindHello. Thank you for your inquiry and congratulations on your surgery! It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind
Hi and welcome to our forum!While submuscular placement may compress the implant, making it slightly flatter and broader with slightly less projection, it will not ultimately have a significant effect upon breast size. The difference between 160 - 190 cc is less than a shot glass and is not very significant. You may desire a second consultation to further discuss implant sizing before electing a small implant.Best wishes...
Hello. Thank you for your inquiry. It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually. Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point. There are many different...
Thanks for your inquiry and so glad to hear your labs are normal! Your question does not have a simple answer and some decisions are not based on science or math or engineering. It is already mid July, it can take you a couple of months to do your consultations and book surgery making it Se...
Hello. Thank you for your inquiry and congratulations on your surgery! It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol. Please ensure to get...