I'm having a difficult time deciding behind or above the muscle? (Photo)
Doctor Answers 15
Dual plane breast augmentation is a submuscular implant position
Where to put a breast implant on top or below the muscle?
Thank you for your story, questions and photos.
I would suggest you visit some reputable board certified plastic surgeons to have complete assessment and review of all your options.
Usually sub muscular augmentation in dual plane is the best option.
If you put a very large implant on top of the muscle it can cause sagging in long term.
Implants and the muscle
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Breast Augmentation: Information
Thank you for your story, questions and photos. Unfortunately with out a exam of your tissues I can can only comment based your photos.
In my practice I personally almost always place implants under the muscle (dual plant) unless the patient is a professional weight lifter (animation issues).
Placement of Breast Implants
1) sub pectoral, dual plane
+ less chance for internal scarring (capsular contracture)
+ padding from the muscle therefore less chance of implant palpability
- varying degree of animation upon pectorals major contraction ( breasts moving)
- longer immediate recovery
2) supra pectoral
+ in borderline ptosis (breast sag) can provide alternative to a mastopexy
+ faster immediate recovery
- increase chance of internal scarring (capsular contracture
- increase potential for breast implant palpability.
I trust that you have chosen a Plastic Surgeons who is experienced and Certified by the American Board of Plastic Surgery. In addition ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
I wish you my best and success,
R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
Above or under the muscles
provides internal support. Use of an anatomic implant will create a natural appearance if that is the goal.
Breast augmentation is all about a healthy conversation between patients and their surgeons. I would recommend finding a plastic surgeon that really listens and tries to understand what your goals are for a natural look especially based on your individual anatomy and chest. A board certified plastic surgeon's office can have sample implants to help you visualize what the implants look like (anatomic, round) and how they feel (textured, smooth, saline versus silicone). Best of luck! MMT
Above or below the muscle
Breast Implants / Breast Augmentation/ Cohesive Gel Implants / Silicone Implants / Revision Breast Surgery
The best way to determine implant size is based on chest wall measurements that fit your body. Once we determine that we can choose the profile based on what you want or need to achieve.
Implants under the muscle, there is less risk of capsular contracture. Anatomic implants tend to give a more natural shape with more nipple projection.
The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
Best of luck!
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
Prominent surgeons from around the world can debate the merits of below versus above the muscle placement, but one thing is for certain that we'd all agree upon is that a large implant like the one you are contemplating will have a prominent upper pole fullness that will not blend with the rest of the chest, creating the 'fake' look.
As for the other issues I stand on the side of the majority of my American colleagues, and feel that dual plane, sub-pectoral placement of an appropriately sized implant, placed correctly will lead to decreased risk of capsular contracture and rippling, with little risk of animation deformity. Above muscle placement will hasten a dropped out look because of release of all the breast/skin attachments to the underlying muscle.
Best of luck!