Am I a candidate for over muscle implants? (Photo)

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. Schwartz

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for a Breast Augmentation.  Always insist on a board certified plastic surgeon.

Hello,When determining if over or under placement is best, the amount of fat/breast tissue present in the upper chest is measured and this will be a strong determining factor. I recommend that you meet with your chosen Plastic Surgeon in person so that they can examine/measure you thoroughly, discuss your concerns and goals, then make a recommendation for you. If you would like a second opinion, I recommend that you meet with another board certified Plastic Surgeon in person.All the best

Hello, if the nipples are lower on the breasts, an over the muscle or dual plane pocket are considerations to help perk up the nipples.  It sounds like you have already had a proper assessment and the surgeon felt that over the muscle was appropriate for your body type.

Due to risk of capsular contracture it is very rare for me to recommend sub glandular breast augmentation. In your case, there is nothing about your desires or preop appearance that would inspire me to do a sub glandular surgery. However, there are many talented plastic surgeons that would use a sub glandular technique so that is not necessarily a wrong answer. Sorry that I couldn't be more definitive! Best of luck!

Thank you for your question.#Submammary or
#subglandular #implants are the placement under the #breast tissue in front of
the muscle. This tends to more common in
Europe and South America. General
guidelines suggest that women with larger drooping (ptosis) breasts that do not
want a breast #lift often have the implant placed above the muscle.

There is absolutely never an indication for over the muscle implants.  It is a very old fashioned approach.  The edges of the implants are more visible, the implants are in contact with the breast tissue so the risk of capsular contracture is higher, the interference with mammography is worse, there is less support for the implants so they sag faster and more severely, the rippling risk is higher, the infection risk is higher, once they are in this position it is nearly impossible to switch them to under.  A surgeon that recommends this approach is indicating their judgement, experience, skill, knowledge, and training.  I would be careful about this decision.  You cannot take this one back.In addition, you are a perfect candidate for a breast augmentation.  You would have an outstanding outcome.  Under the muscle every time in 2016.  Over the muscle every time in 1965.  There are
many advantages to sub muscular dual plane placement and very many
disadvantages to sub glandular placement. I would see no indication to do
anything but sub muscular. This can be best accomplished with the armpit
approach. The most sophisticated approach to breast augmentation is through the
armpit with a surgical camera (transaxillary endoscopic). Using this modern
approach the space can be crafted under direct vision, with virtually no
bleeding and no postoperative bruising. Most importantly, the shape of the
breast is meticulously created. The other, older methods of insertion are
technologically less advanced. Both silicone and saline implants can be placed
through the armpit by a surgeon with skill and experience using this approach.
The incision in the crease is the oldest method of placing the implants and
puts a scar directly on the breast.

Subglandular
silicone implant placement is the historical approach to this surgery, and was
widely used in the 1960's. The implant edges are more visible, the risk of
rippling is higher, the implant is in contact with the non-sterile breast
tissue so the risk of infection and capsular contracture is higher. The
interface between the breast tissue and the muscle is blurred so the implant interferes
with mammography more than sub muscular placement. The blood supply surrounding
the implant is worse so the risk of capsular contracture is higher. The support
for the implant is less so there is more long term shape abnormalities and
sagging. The look of a sub glandular implant is much less appealing than a sub
muscular implant. The placement of sub glandular implants makes any subsequent
revision surgeries more complicated and less successful. There are no
advantages to sub glandular implant placement.

 My own personal opinion is that implants do better under the muscle. There is a lower rate of capsular contracture and I think the upper pole looks more natural.   For you a dual plane 3 might give you the best of both worlds. Good luck!

Dear mckayla11:It looks like you will likely get a great result from breast
augmentation. I think you would benefit from a breast augmentation with a
dual plane technique.
In terms of picking the right implants to
achieve your
goals, generally speaking, I consider two
factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional
planning – The measurements of your chest wall are taken. Also, the
breast dimensions including the height, width, and current dimensions of
each breast form the basis of dimensional planning. Based on these
measurements, the implant size is recommended. This will give you a
unique breast implant that is suited for your body frame. However, there
are some limitations of what size we can recommend. For instance, some
implants may just be too big for a narrow chest wall. Your surgeon can
review this with you during the consultation.Gel Implant Sizing
system – During the preliminary breast implant consultation, you will
be provided with an option to “try on” a variety of implant shapes and
sizes. You can also visualize the possible outcomes of your surgery
which helps you to get that perfect size to give you the shape that you
longed for. This way your preferences are known and you can then pick a
range of implants that will “fit” just right to give a soft natural
fuller look. Hope this helps.Dr. BasuHouston, TX

Thanks for your question, your photos are very helpful.  In my San Antonio Plastic Surgery Practice, I very rarely place implants above the muscle.  I think most surgeons today would agree that submuscular implant placement is the preferred method.  I would recommend you see a few Board Certified Plastic Surgeons in your area to get other opinions.  A 500cc implant placed above the implant will be clearly visible and will likely have a higher incidence of Capsular Contracture.