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.
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.
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.
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: 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!
Helpful
