Highly cohesive gel implant over the muscle? (photos)

Hello Sierralynn, and thank you for your
questions. It sounds as though you're doing thorough research prior to your
breast augmentation, which is wonderful. It's important to remember that no 2
doctors are alike, and we often make recommendations for our patients based on
our own previous experiences, which can vary. Without an in-person appointment,
it's difficult to say why your doctor recommended a subglandular placement.
It's possible that the location or position of your existing breast tissue
would make that placement the better option for you. As for the surface of your
implants, some doctors prefer the textured variety because they can reduce the
incidence of certain complications, particularly capsular contracture. For
patients in search of a very natural outcome, I typically recommend a
submuscular placement. You should feel comfortable asking your doctor why he or
she recommends the plan you described. You may also consider consulting with
multiple board-certified plastic surgeons in your area until you find one who
shares your vision. Good luck!

I can only give you my opinion, but in patients with the anatomy displayed in your photos I would most definitely suggest under the muscle. Your upper pole soft tissue coverage is so thin you will surely see at least a hint of implant edge and possibly more. All implants are cohesive now and just vary in degree, but the highly cohesive can lose the natural feel that is one of the benefits of the silicone. I prefer smooth implants for most patients as they have the ability to move slightly as does natural breast tissue. That is not the case with the textured devices.You might want to see more than one surgeon for consultation.