Would I be able to have a subglandular augmentation? (Photo)

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

Hi, thank you for sharing your question. You seem to be a good candidate for subglandular breast augmentation, however, there are some advantages & disadvantages that you should discuss with your board certified plastic surgeon before you decide. All options for augmentation can be tailored to look natural and “keep them guessing”. I hope this helps. Best of luck! 

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.

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
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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!

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

Hello dear!
Thank you for your question and provided information as well..
Based on your photos, it seems that you have symmetrical breasts for which you wish to add more volume. There are many ways that plastic surgeons perform measurements in order to determine which breast implant size, style and shape will best suit your goals. It is important that you communicate to your board-certified plastic surgeon what are expecting, to make certain that your goals are realistic. It's helpful to show pictures of results you'd like, but please keep in mind that these are other people and your body is different from everybody. In my office, we use a method of sizing with silicone gel forms of known volumes. This is proven to be a very accurate means of determining what size will might be of additional interest to you as well.
Know that 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.   
Hope this helps and best of lucks.
Dr. Luis Mejia.

Hello and great question. I appreciate the time you are spending researching this procedure. My name is Dr. Matthew J. Nykiel. I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Breast Augmentation Specialist.
Based off of your photos you would be a great candidate for breast implants. When deciding between placing implants over or under the muscle it is important to keep in mind the advantage/disadvantages of each option. Implants placed under the muscle are less likely to form a capsule, look more natural look and show less rippling/implant visibility.  
I would definitely recommend doing an in person consultation with a board certified plastic surgeon who specializes in this procedure and who can suggest what is needed. 
I hope that helps! Best of Luck! 
Matthew J. Nykiel MD

Thanks for your inquiry and picture, given the amount of volume you have, you could consider either above or below the muscle, best of luck.

Hello, thank you for your question. It seems like you can benefit from a submuscular breast augmentation, I recommend you to schedule an email, Skype or in-person consultation with a board certified plastic surgeon for proper evaluation. 

Hello and thank you for your question and sharing your photo. You seem to be a good candidate for  breast augmentation. You do have enough breast tissue and so you can go either way. Advantages of  submuscular placement of the implant is
less likelihood for capsule formation, more natural look and less
rippling/implant visibility. As there is a layer of muscle separating the
implant from the breast tissue, there will also be less interference with
mammograms.
Best
wishes and good luck,
Pejman
Aflaki, M.D. Johns Hopkins-trained double board-certified plastic surgeon