I’m 5’9” 125lbs & going in for my BA surgery next Wed & my surgeon wants to do over the muscle (OTM) given my anatomy. He mentioned the possibility of the implants moving to the side if he went UTM, especially since I want a fuller look. I worry about capsular contracture & that going OTM will look unnatural and will show rippling. I chose the above implant size options thinking the procedure would be done under the muscle & now I am concerned those sizes are too big for OTM.
Answer: Breast Augmentation Thank you for your question. A large portion of my practice is dedicated to revisionary breast surgery. I do see many patients who are fooled into thinking that they can have a implant placed on top of the muscle, and that this will fill up the breast implant envelope. This only works if we live on Mars. Imagine that you are already drooping and now place a weight on top of your muscle. The inevitable event will be that your breast will continue to droop. You or exactly this case scenario. If you placed her implants on top your muscle you will be very disappointed with the result in the next 6-8 months. I have a whole revisionary breast practice based on this short sided thinking. On the other hand, you are an excellent candidate for a dual plane breast augmentation and mastopexy (lift). Best wishes to you.
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Answer: Breast Augmentation Thank you for your question. A large portion of my practice is dedicated to revisionary breast surgery. I do see many patients who are fooled into thinking that they can have a implant placed on top of the muscle, and that this will fill up the breast implant envelope. This only works if we live on Mars. Imagine that you are already drooping and now place a weight on top of your muscle. The inevitable event will be that your breast will continue to droop. You or exactly this case scenario. If you placed her implants on top your muscle you will be very disappointed with the result in the next 6-8 months. I have a whole revisionary breast practice based on this short sided thinking. On the other hand, you are an excellent candidate for a dual plane breast augmentation and mastopexy (lift). Best wishes to you.
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Answer: Over vs Under Good evening,
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Answer: Over vs Under Good evening,
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April 13, 2021
Answer: Bellesoma Lift Implants alone will not solve your problem. 565 cc or 595 cc implants are much too large, will not fit under the muscle and will weigh down the breasts. The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.
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April 13, 2021
Answer: Bellesoma Lift Implants alone will not solve your problem. 565 cc or 595 cc implants are much too large, will not fit under the muscle and will weigh down the breasts. The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.
Helpful
April 13, 2021
Answer: Are over the muscle implants the right choice for me? 565cc or 595cc HP over the muscle (subglandular) implants (Photo) There are several advantages to going under the muscle. You will typically have a more natural appearance to the upper part of your breast. The action of your muscle will help massage the implant and keep the scar tissue capsule soft. The muscle protects the implant from the natural bacteria in your breast to decrease the risk of infection and capsular contracture. Going over the muscle does allow for more “lift” but if a “dual plane” approach is taken you can pair the advantages of both approaches.
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April 13, 2021
Answer: Are over the muscle implants the right choice for me? 565cc or 595cc HP over the muscle (subglandular) implants (Photo) There are several advantages to going under the muscle. You will typically have a more natural appearance to the upper part of your breast. The action of your muscle will help massage the implant and keep the scar tissue capsule soft. The muscle protects the implant from the natural bacteria in your breast to decrease the risk of infection and capsular contracture. Going over the muscle does allow for more “lift” but if a “dual plane” approach is taken you can pair the advantages of both approaches.
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April 11, 2021
Answer: Implant position. You are right, over the muscle puts you at not only higher risk of capsular contracture and implant visibility and rippling, but also implant dropout due to tissue stretch/loss of support from deep structures (the pec major muscle). Further, your surgeon has likely made this recommendation because of your breast ptosis, and the need for a breast lift. Although the initial outcome might appear ok, it won’t be long before you realize that you have not escaped the need for a lift, and are now exposed to all the aforementioned complications. I would strongly advise you to rethink this plan. If you fear the scars of a breast lift, than I encourage you to do nothing rather than to do the wrong thing. Finally, you have to ask yourself the motive of your surgeon to recommend this, and not the most evidence based best surgery: an implant placed into the subpectoral position and a formal breast lift. It’s either because he fears your disapproval because of scars or extra cost, or he does not have confidence in his ability to perform a breast lift well (a much more difficult procedure than an implant based augmentation), or he simply lacks the training or ability.
Helpful
April 11, 2021
Answer: Implant position. You are right, over the muscle puts you at not only higher risk of capsular contracture and implant visibility and rippling, but also implant dropout due to tissue stretch/loss of support from deep structures (the pec major muscle). Further, your surgeon has likely made this recommendation because of your breast ptosis, and the need for a breast lift. Although the initial outcome might appear ok, it won’t be long before you realize that you have not escaped the need for a lift, and are now exposed to all the aforementioned complications. I would strongly advise you to rethink this plan. If you fear the scars of a breast lift, than I encourage you to do nothing rather than to do the wrong thing. Finally, you have to ask yourself the motive of your surgeon to recommend this, and not the most evidence based best surgery: an implant placed into the subpectoral position and a formal breast lift. It’s either because he fears your disapproval because of scars or extra cost, or he does not have confidence in his ability to perform a breast lift well (a much more difficult procedure than an implant based augmentation), or he simply lacks the training or ability.
Helpful
April 11, 2021
Answer: Under the muscle Hi. Your concerns are correct! If you have implants OTM, there is a higher incidence of contracture. But more importantly, the weight of the implants will cause your breasts to sag more rapidly over time. In a few years, you won’t be happy with the stretching and sagging that has occurred. Talk to your surgeon about these issues prior to the day of the surgery. Best of luck!
Helpful
April 11, 2021
Answer: Under the muscle Hi. Your concerns are correct! If you have implants OTM, there is a higher incidence of contracture. But more importantly, the weight of the implants will cause your breasts to sag more rapidly over time. In a few years, you won’t be happy with the stretching and sagging that has occurred. Talk to your surgeon about these issues prior to the day of the surgery. Best of luck!
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