Placing the implants under the muscle generally yields a more natural look and less risk of rippling because there’s more tissue to camouflage them. Since your plastic surgeon recommended a mini lift with the submuscular option, this tells me there’s some degree of ptosis (sagging). Therefore, it is important to understand that Option 2, without the lift, will not give you a perky look, if that’s your goal. However, if getting back to the gym is your main concern, placing implants over the muscle (subglandular) is less invasive and generally means a faster, easier recovery. This option may let you return to your CrossFit activities slightly sooner than submuscular placement. My feeling is that submuscular placement will be better for you in the long run but I suggest that you carefully weigh these and other pros and cons and continue to discuss this decision with your plastic surgeon until you feel confident which option is best for you.
I appreciate your question.
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!
Dr. SchwartzBoard Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
Thank you for the question.
There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”. I will try to outline some of the differences here; you may find the attached link helpful as well.
I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).
The submuscular positioning also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.
On the other hand, sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle) they can be seen with breast implants placed in these sub muscular position.
Best wishes with your upcoming surgery.
If you want the very perky look option one is your best option. If you did not want a lift, I would probably offer you a dual plane augmentation to avoid the lift but have most of the implant covered by muscle as the second option. It is my opinion that under the muscle gives a much better long term softness and coverage with natural tissue. Your return to cross fit might be delayed a little longer, but I think it is worth it for the long term benefits. I have done several body builders, personal trainers, and even one female Marine drill instructor with implants under the muscle and it has worked great for them. Good luck.