Breast Augmentation - should I go with over muscle tear drop implants?

Question

I am 27 years old 5’7 and 127 pounds. I went to a breast augmentation consultation and the doctor reccomended 300 cc over the muscle tear drop implants. I am sceptical abov going over the muscle but he says I have enough tissue and I am also worried whether I am making the right decision of chosing tear drop. Any doctor feedback is greatly appreciated.

Ajaya Kashyap, MD · Answer

Thank you for your query. The choice of implants and their shape depends on your anatomy, your surgeon and your preference. Over the muscle placement of implants can be done when there is  a minimum of 2 cm of breast tissue above the implants, which your surgeon must have checked. I do not prefer tear drop shaped implants except for best breast reconstruction but these work well for many surgeons. Round implants can also work well. Please discuss all your options at length with your Plastic surgeon who can help you with all your concerns. All the best!

Randal Haworth, MD, FACS · Answer

The decision to undergo breast augmentation is a personal one, and it is important to consider all factors, including the type of implant, placement, and size.

Over the muscle breast augmentation can be a suitable option for some patients, particularly those with adequate breast tissue or those who are looking for a more natural-looking result. However, there are some potential drawbacks to this approach, including a higher risk of visible implant edges or rippling, as well as a potential for a more rounded appearance.

Teardrop implants, also known as anatomical implants, are designed to mimic the natural shape of the breast and can provide a more natural-looking result, particularly for patients with a smaller frame or those seeking a subtle enhancement. However, these implants can be more difficult to place correctly and require a skilled surgeon with experience in this technique.

Ultimately, the choice of implant type and placement will depend on your individual goals, anatomy, and other factors. It is essential to have a consultation with a board-certified plastic surgeon who can evaluate your unique situation and recommend the best approach for you. It is also important to ask any questions you may have and to have a thorough understanding of the risks and benefits of the procedure before making a decision.

I hope this helps,
Best of luck !

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Andrea Marando, MD · Answer

Thank you for your question. The decision the decision to go above or under the muscle depends on several factors such as the existing glandular tissue you have, the position of the nipple, degree of laxity / skin excess and desired size of the final breast ... It is difficult to advise you without at least photographs or accurate physical examination. Therefore you will have to trust your surgeon on this. 
If you in two minds and would like to have some more information, it might be an option to go and see another surgeon for a second opinion.

I wish you all the best for your procedure.

Andrea Marando
Consultant Plastic and Cosmetic Surgeon at Star Clinic
Manchester and London, UK

Daniel Barrett, MD · Answer

Dear Eclectic568757,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

Implants are always more palpable over the muscle, even when women 'have enough' tissue. More importantly, there is a higher risk of capsular contracture when implants are placed over the muscle. 'Tear drop' shaped implants have been shown not to have a different outcome from similarly sized round implants. Further, all shaped implants are textured for the purpose of 'locking' the implants into position, to maintain their orientation on the chestwall. The problem is that most patients develop mobility anyway, which can lead to implant rotation and deformation of the breast mound (between 5% to 40%). The other problem with textured implants is that there is a very low risk of developing a rare lymphoma (1/70000). With smooth implants, the risk of either rotation or lymphoma are zero. Choose under the muscle with round and smooth implants.

Andrew T. Cohen, MD, FACS · Answer

I would do smooth round under the muscle for best results. No one is using tear drop any more. Smooth round under the muscle is the best. Just my humble opinion. Best to see a board certified plastic surgeon.

Good luck!

Andrew Cohen, MD

Good luck!

Andrew Cohen, MD

Peter Andolina, DO · Answer

I typically like to place my implants under the muscle in my patients unless they are professional athletes or body builders.  I think the overall look and longevity of the augmentation is better with this approach.  I also prefer round shape implants as opposed to anatomical or tear drop implants.  In my opinion round implants once again look better in patients and give better upper pole fullness which seems to be very important for patients.

Connie Hiers, MD, FACS · Answer

You did not show photos, so I cannot be specific. However, your surgeon who has examined you knows how much actual breast tissue is present and can guide you to the best location for your implant.

Camille Cash, MD · Answer

An examination and discussion of your goals is really needed to give you a proper recommendation.  There are pros and cons to tear drop implants, the main one being they have a potential to turn/flip.  The majority of my patients elect to have the implants placed beneath the muscle.  This allows for the upper portion of the implant to be disguised by the muscle.  This approach also carries a lower risk of capsular contracture.  I encourage you to discuss your concerns with your surgeon to determine what is right for you.

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