Hi I'm looking to get 800cc implants but have been told my surgeon does not do under the muscle. I want under the muscle because I have had a child so my skin is thin and I worry that if I get large implants over the muscle then I will end up with rippling. Will this happen? I have another appointment with him on Monday if he refuses to do under the muscle should I look for another surgeon? Thank
January 22, 2017
Answer: Will I get rippling from 800cc implants over the muscle? 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) that can be seen with breast implants placed in the sub muscular position. I hope this (and the attached link, dedicated to "larger" breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.
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January 22, 2017
Answer: Will I get rippling from 800cc implants over the muscle? 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) that can be seen with breast implants placed in the sub muscular position. I hope this (and the attached link, dedicated to "larger" breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.
Helpful
January 22, 2017
Answer: Breast augmentation Hello and thank you for your question. The best advice you can receive is from an in-person consultation. It is very unusual if your surgeon is board-certified by the American Board of Plastic Surgery that he/she would not be able to place implants under the muscle. There are several advantages and disadvantages to over vs under the muscle. Under the muscle has the advantage of lower capsular contracture rates, less risk of rippling, and better visualization with future mammograms. Most patients say that under the muscle also has a more natural look and feel. The size, shape, and profile 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. This entire surgery can be performed with a small incision technique. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. Harvard-trained plastic surgeon
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January 22, 2017
Answer: Breast augmentation Hello and thank you for your question. The best advice you can receive is from an in-person consultation. It is very unusual if your surgeon is board-certified by the American Board of Plastic Surgery that he/she would not be able to place implants under the muscle. There are several advantages and disadvantages to over vs under the muscle. Under the muscle has the advantage of lower capsular contracture rates, less risk of rippling, and better visualization with future mammograms. Most patients say that under the muscle also has a more natural look and feel. The size, shape, and profile 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. This entire surgery can be performed with a small incision technique. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. Harvard-trained plastic surgeon
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