Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity
Based on what I see in the photos, you may be best served with a mastopexy only. You have significant sag and volume that needs to be addressed. Depending on your expectations, you may be happy with the result. You can add implants at a later date if needed.
It is clear based on photos that a breast lift will be required. The presence of stretch marks also indicates to me that you are at a higher risk of recurrent sagging in the future that may occur sooner than if the stretch marks were not present. In your circumstance, then I commonly recommend subglandular placement of implants. I feel that as the breast ages, the implants stay in better harmony with your breast tissue. This helps to reduce the risk of having a "snoopy" or "double bubble" deformity in the future. The only thing that would deter me from subglandular placement would be if the amount of breast tissue that can be pinched on the upper part of the breast is less than an inch thick. That would make your risk of visible rippling great enough that submuscular placement would be an advantage.
Your photos can tell that you need a breast lift procedure. Pictures can only tell so much. I highly recommend that you have an evaluation with a board certified plastic surgeon. Special measurements need to be taken to determine the new position of the areolas. Also the doctor will need to see if you are a candidate for subglandular or if you will need to go sub muscular. If your skin is thin on the upper pole of the breast, the implants will need to go behind the muscle otherwise the border the implants will be seen through the skin. The implants need sufficient coverage for the best results. If the best option is submuscular, you will not be able to do chest exercises which will contract the muscle and put pressure on the implants. You will be able to do shoulder, biceps, triceps, abdominal and leg exercises without a problem. Please let us know what the recommendation is! Good luck!
This is not always easy.I assume you are not a smoker but you for sure need a lift.I would at the same time decrease the size of your nipple areolar complex as well.Another thing I would consider is to do a composite lift/aug wherein we would use your own fat to help build up the soft tissue of your breast.You get an area of liposuction and I think get a better result and perhaps a small impalnt depending on how big you want to be.
You might want to consider staging your operations. Stage 1 would be full lifting. Than after 3 months decide upon the size/volume of implant and placement above or below the muscle.
Thank you for your question about your breast implants.
- Your photos show of course that you need a breast lift
- If you want to be larger, then you also need implants.
- Over-the-muscle implants may be better if your job requires regular work-outs.
- But over-the-muscle implants are not usually placed at the the time of lift.
- Consult a plastic surgeon to discuss the pros/cons of a lift and implants and if this should be done together.
- Done together, it is important to realize that a second operation is still very often needed 6 months later.
- Which is best for you will depend a lot on your available recovery time.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.
If you are frankly unhappy with your breast size when you are tucked into a bra than an augment would be worthwhile. That being said a breast lift alone with tightening only of the skin brasier and no excision of breast tissue would likely give you a lovely well shaped and lifted C breast. The beauty of considering lift alone is that you will incur much less cost, will get a very stable long-term outcome that will likely not require any further upkeep surgery - and it will feel more comfortable given how athletic you are. You can also consider breast lifting with fat grafting to give you a subtle enhancement of volume while you lift. Regardless, if you improve your shape you can better decide if more volume is actually needed. I find many women in my practice are very happy after breast lift surgery alone..excellent contour and lift and its all your own breast tissue. If you want to add volume down the road you can always do so.
My preference in athletic patients is to place the implants in the sub-fascial position.
Mesh support can also be considered
The are pros and cons to each method of implant placement. If you work out a lot, then the weight of the breast plus implant in a subglandular placement will affect the position of your breasts sooner and to a greater degree than submuscular. Submuscular implants have fewer complications, but you can see displacement of the implant when the muscles are flexed. Strength of the chest muscles has not been shown to be a problem in weight lifters.