Sub-glandular Breast Implants
If you are a perfectionist, you may not want breast implants, especially in the sub-glandular position. They tend to get higher rates of capsular contracture, especially when placed through a peri-areolar incision. They tend to be visible, palpable, and with rippling in both the upper and lower poles due to lack of tissue thickness.
With implants in the sub-pectoral/dual plane position, capsular contracture rates tend to be lower, especially when placed through an inframammary incision. However, you can get some animation motion/deformity as well as some loss of overall pectoral strength.
You have a pleasing breast shape with a natural crease and enough volume to support a sub-glandularly placed implant. If you were to go forward, I would recommend a smaller, textured implant, one based on your bio-dimensional measurements. I would also consider a form stable/anatomical device as well, as these tend to ripple least.
Best of luck!
Yes you can achieve a nice round look with subglandular implants. You do not have much breast droop, but you do have deflation due to breastfeeding. Sometimes with deflated breasts, the skin tends to be a bit thinner. Placing implants under the breast gland in your situation could potentially lead to more rippling and implant show since the skin is already thinner. Thus a proper physical examination is imperative to see how much tissue you have and a proper recommendation can be provided so that all the advantages and disadvantages can be explained to you. With that said, sub glandular implants can still be a good option for you. Good luck.
Can I achieve a nice round look with sub glandular implant placement
I think the best chance of getting a round upper pole with no slope would be a textured round implant above the muscle, taking into consideration your concerns.
I would not suggest subglandular placement. All studies have shown the submuscular placement is superior. Total or partial muscle coverage depends on your anatomy and requires in person physical examination to evaluate your skin and soft tissue coverage. You have quite symmetrical breasts and will likely get a fantastic result. You are starting the right way by asking lots of questions. Keep in mind at least 300cc is required in a 5'4" woman to get a one cup increase in size. Unless you are shorter in height 240cc will not enhance you a great deal. Good luck!
However, submuscular coverage will be better choice to reduce future scar tissue and visibility. Consult with Board Certified Plastic Surgeon.
Can I achieve a nice round appearance with subglandular placement?
With silicone implants back on the market for the past 8 years, more plastic surgeons have been trending toward a subglandular placement since silicone implants don't have the same problems as saline with visible rippling and palpability. So this is certainly an option for you. However, my concern is that you want a nice round look and you are already starting with a decent amount of breast size and don't want to be a lot bigger. While your breasts don't have any ptosis (droopiness) of the nipple, the do have what could be consider some "pseudoptosis" or bottoming out where much of your breast tissue is below rather than above your nipple. I'm concerned that placing the implants in the subglandular position will over time worsen this problem rather than achieving the full/rounded look you want. Without an exam in person, it is difficult to make exact recommendations, but you may even be a candidate for a lift with implants to help reposition your breast tissue so that you can achieve the look you want without going with really large implants--I doubt you're going to get the look you want with 200-240cc implants in either position (above or below the muscle). I hope that makes sense. I would recommend consulting with several board certified plastic surgeons so that you get the result you want. Best of luck!
Breast augmentation implant
breast augmentation can be of multiple choices.
each choice have its limitations.
retromuscular has its advantages as well as retroglandular
one important thing is to know the surgeon comfort with the procedure you are asking for.
retroglandular has higher risk of capsular contracture ( firmness) and need to be silicone implant.
looking at your picture, I think you have enough soft tissue coverage to have it retroglandular.
Advantages to Both Options
Thanks for your
question. As my colleagues have mentioned, it is very difficult to give you a
satisfying, specific answer without a physical evaluation. The short answer is
that both the subglandular and the submuscular options come with their own
specific advantages and drawbacks. Many women have a difficult time deciding
whether or not to go through the added discomfort and healing time involved
with submuscular or dual-plane placement. When you add weight lifting into the
mix, your decision becomes a little more difficult.
I think you'll
find that most plastic surgeons prefer the submuscular or dual-plane placement,
as studies and experience tend to support better outcomes with this approach.
However, every woman is different, and for some, subglandular is a good option.
With today's variety of shapes and styles of cohesive silicone gel implants, we
can achieve beautiful results with subglandular placement for the right
candidates. The ideal candidate for subglandular placement is someone with
enough of her own natural breast tissue and little to no sagging.
While your breasts
are very nicely shaped, you do show some deflation, particularly in the upper pole,
and you may want to consider a breast lift with your breast augmentation. This
is a determination that can only be made by a surgeon at an in-person
consultation. Seek out a board-certified plastic surgeon, and be very clear
with him or her about your expectations and concerns. Good luck to you, and
keep us posted on your progress!
Sub glandular implants.
Absolutely, you can and will get a very natural and pleasing result with smooth silicone implants in the subglandular position, which is the only place I put the implants.
I have published this in the "bible" of Plastic Surgery, an 8 volume text book edited by Mathes.
Malcolm Lesavoy, MD
Round Look from Breast Implants
I think subglandular placement is advisable for you but keep in mind that there are always compromises to resolve when choosing breast augmentation after childbearing. Your breast shape is quite favorable however you have enough skin that a larger implant than 240 ccs would probably be necessary to achieve a round appearance such as in your last photo. The first "ideal" photo that you posted is of a patient with anatomy quite different from yours. My preference would be to lean toward a mid profile round smooth silicone implant due to the lowered risk of waviness when compared to a textured implant in a subglandular position. Slightly higher risk of capsular contracture in that position, but less risk of rippling. Others will disagree based on their experience. Be realistic with your doctor so you understand what you can reasonably expect and what the risks are. Good luck and enjoy no matter what your decision!