I am considering a breast augmentation and would like fuller breasts. I am happy with the shape I would just like an increase in size. I would like natural looking results (“keep them guessing”) and am wondering if I would be able to have a subglandular augmentation without too much upper pole fullness, distinct borders or an “augmented look.”
Answer: Breast Augmentation Thank you for your question.You are an ideal candidate for a breast augmentation. There are potential advantages and disadvantages to placing the implants above or below the muscle. I recommend that you see a few board certified plastic surgeons in consultation
Helpful 2 people found this helpful
Answer: Breast Augmentation Thank you for your question.You are an ideal candidate for a breast augmentation. There are potential advantages and disadvantages to placing the implants above or below the muscle. I recommend that you see a few board certified plastic surgeons in consultation
Helpful 2 people found this helpful
Answer: Over vs. Under 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. As always, discuss your concerns with a board certified plastic surgeon (ABPS). Donovan Rosas MD Board Certified by the American Board of Plastic Surgery Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons RealSelf Verified Member RealSelf Top 100 RealSelf Hall of Fame
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Answer: Over vs. Under 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. As always, discuss your concerns with a board certified plastic surgeon (ABPS). Donovan Rosas MD Board Certified by the American Board of Plastic Surgery Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons RealSelf Verified Member RealSelf Top 100 RealSelf Hall of Fame
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May 4, 2020
Answer: Implants Just based on your one phot, you appear to have enough breast tissue to have the implants placed behind the breast. You may find over time that the upper edge of the implant shows through and sagging. I would suggest not choosing large and heavy implants.
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May 4, 2020
Answer: Implants Just based on your one phot, you appear to have enough breast tissue to have the implants placed behind the breast. You may find over time that the upper edge of the implant shows through and sagging. I would suggest not choosing large and heavy implants.
Helpful
April 17, 2020
Answer: Subgrandular breast augmentation Hello, Thank you for your question. If appears from your picture that you may have enough breast tissue to have a subgrandular breast augmentation. There are advantages and disadvantages for placing the breast implants above and below the muscle. Your lifestyle and goals should be considered. I recommend that you seek a formal consultation with a plastic surgeon for a full assessment. Good luck!
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April 17, 2020
Answer: Subgrandular breast augmentation Hello, Thank you for your question. If appears from your picture that you may have enough breast tissue to have a subgrandular breast augmentation. There are advantages and disadvantages for placing the breast implants above and below the muscle. Your lifestyle and goals should be considered. I recommend that you seek a formal consultation with a plastic surgeon for a full assessment. Good luck!
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April 16, 2020
Answer: Would I be able to have a subglandular augmentation? There appear to be no major contraindications to placement of your implants above the muscle, so this should be a viable option if this is your preference. Seek a consultation with a board certified plastic surgeon to allow you to thoroughly understand the relative risks and benefits of subglandular vs. submuscular augmentation.
Helpful 1 person found this helpful
April 16, 2020
Answer: Would I be able to have a subglandular augmentation? There appear to be no major contraindications to placement of your implants above the muscle, so this should be a viable option if this is your preference. Seek a consultation with a board certified plastic surgeon to allow you to thoroughly understand the relative risks and benefits of subglandular vs. submuscular augmentation.
Helpful 1 person found this helpful
April 14, 2020
Answer: Implant placement Great question! Absolutely you can have an implants placed in a sub glandular position. The specific details of the advantages and disadvantages of placing the implant above or below the muscle can be discussed during your consultation. It is also very important to pick the appropriate implants size and projection to give you that natural look. Seek a consultation with a board-certified plastic surgeon to go over the details of this procedure Best of luck and hope this information helps! - Dr. Roger Tsai @DrRogerTsai Board Certified Plastic Surgeon
Helpful 1 person found this helpful
April 14, 2020
Answer: Implant placement Great question! Absolutely you can have an implants placed in a sub glandular position. The specific details of the advantages and disadvantages of placing the implant above or below the muscle can be discussed during your consultation. It is also very important to pick the appropriate implants size and projection to give you that natural look. Seek a consultation with a board-certified plastic surgeon to go over the details of this procedure Best of luck and hope this information helps! - Dr. Roger Tsai @DrRogerTsai Board Certified Plastic Surgeon
Helpful 1 person found this helpful