Are 500cc subglandular silicone implants a good idea? (Photo)

Question

I am not ready to do a breast lift, but my dr suggested doing 500cc high profile silicone subglandular. I am 5'7" 150lbs., breast width 13cm...I have lost 100lbs, and want to fill in some, I know a breast life is most likely the best option, but I'm not ready for that just yet.

Michael E. Decherd, MD, FACS · Answer

I just think a sub glandular implant is a bad operation.  Over time they look worse (my opinion) and they get more capsular contracture (scientific data).  Go submuscular.

Gary Lawton, MD, FACS · Answer

You look like an excellent candidate for a breast lift.  A breast augmentation with sub glandular implants is not a very sophisticated approach to your anatomy, and will give you a compromised outcome.  Doing a lift after you try out the implants first is even a worse idea.

Gerald Minniti, MD, FACS · Answer

Hello, It's a bad idea.  It's old fashion thinking. You'll end up with large sagging breasts, palpable implants, and a higher risk of capsular contracture. See a few expert surgeons who do breast lifts.  You'll see you can have beautiful breasts with inconspicuous scaring.Breast implants do best under the muscle. If you're not ready for a breast lift, than don't do anything. Best set of luck!

Paul W. Papillion, MD · Answer

Ask you doctor to show you pictures of someone with moderate breast ptosis "sagging" who had 500cc implants sub glandular that have been in for 5 years. Then you can see what the expected outcome is. Many plastic surgeons including myself, feel the long term result of a large sub glandular implant is not a good one. You have to decide what look you want. I don't think you would be happy long term.  Good Luck.

M. Scott Haydon, MD · Answer

Thanks for your question and the photos. Frankly, I think that 500CC subglandular HP implants is a terrible choice. You have done such a great job with your weight loss. I would hate for you to realize that your result is very unsatisfactory. First of all, you are right about needing a lift. To try and replace a lift with large implants is a very wrong approach. You appear to have an appreciable asymmetry that will be compounded by the placement of such large implants. I would rather you do nothing than to be unhappy. Congrats again on your weight loss. Best of Luck!

John LoMonaco, MD, FACS · Answer

I agree breast lift is your best "Plan A."  In my opinion, plan B is to do nothing.  A heavy breast implant is going to further stretch your skin and make your breast lower. This effect is often exaggerated in patients who have lost a  lot of weight.  Doing a lift several years after a large implant has further thinned the skin is a much more challenging and unpredictable case in my experience.  I'm just thinking on down the road for you.

Michael Baumholtz, MD, FACS · Answer

There are patients that clearly don't need a lift, clearly do need a lift, and those that are in between.i tell my in btween pts that a larger implant can offset the need for a lift but there are trades to be made (1) you need a larger implant - often bigger than what the pt wanted (2) there will come a point where larger and larger implants are no longer an option and (3) even with a large implant - an adjustment to nipple position may still be needed.i tell pts that if they are not convinced they want a lift and they like the look of the added volume - start there. A lift can always be added later.good luck on your journey and always seek the opinion of a board certified plastic surgeon.

Ravi Somayazula, DO · Answer

Although you are not keen on the idea of the scars associated with a breast lift, most women are not. However placing subglandular 500 cc breast implants in the hopes that you will have a long term good result is asking for problems. You should definitely see some after pictures of patients who've had breast lifts and see for yourself how inconspicuous the scars can be. I'm sure then you will likely understand that trading scars for a better shape and look is worth it. Hope this helps, good luck!

Marcus L. Peterson, MD · Answer

If you need a breast lift then the best option is to do a breast lift.  If you want bigger breasts then use implants of the size you desire.  Try not to mix the two concepts.  You do not want to use large implant just to lift the breasts.  Putting the implants in the subglandular position is a compromise for long term good results.  The best thing to do is  to make decisions that will last a long time and try not to just patch things up right now.Best WishesDr. Peterson

Scott E. Kasden, MD, FACS · Answer

Congratulations SaTxgrl on your weight loss.  You look great!I do quite a lot of breast implants in a given year, and one of my professional passions is taking care of weight loss patients, so I totally understand your feelings (I think), and I understand what is going on with your breasts.You have grade c ptosis of the breasts, which simply means that you need a lift.  One of the reasons for this is that time, gravity, and the weight as well as weight loss has created the situation where you have lost glandular tissue which gives you the fullness you seek, while stretching out the skin envelope.  Additionally, and very importantly, the supporting structures are stretched and weakened.  In essence, the breast and nipples are low, you have too much skin, and not enough to fill the skin envelope.If you just go with an implant only, it will have to be placed too low to be aesthetic or, if placed in a good location, the breast tissue will likely fall off the implant giving you a double bubble appearance.  Given that your tissues are weak from the weight issues cited above, it is my humble opinion that placing the implant above the muscle will not give a long lasting favorable result.  I would urge you to go sub muscular, so that the muscle can add strength and act as an internal bra.Best to you.sek

Are 500cc subglandular silicone implants a good idea? (Photo)

Answers (15)

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