Subfascial Breast Augmentation. Which implant shape is best for subfascial breast augmentation? (photo)

I have decided to go w subfascial placement.I have a hard time deciding between Mentor textured round moderate plus & Mentor tear drop tall height moderate plus implants around 250-300cc's. I want more volume on the upper pole but I don't want the round implant to show on the upper pole.It's also very important for me that the breast implant isn't too short in height for the upper pole projection.I saw nice results w tear drop shaped implants on patients w droopy breasts in subfascial placement.

Doctor Answers 10

Operative plan: round or teardrop?

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I'm not convinced by the data on subfascial breast augmentation.  If you want more upper pole fullness, but don't want the implant to show, why not consider a round implant in a dual-plane (partial sub-pectoral) position?  That approach seems to answer all the things you want.

Subfascial Breast Augmentation. Which implant shape is best for subfascial breast augmentation?

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I recommend submuscular breast augmentation.  Subfascial breast augmentation in my opinion is wishful thinking as the pectoralis fascia is so thin it is typically torn during surgery which results in his subglandular augmentation.

Since you're concerned about upper pole fullness a round implant may be your best option.

Which implant shape is best?

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You will undoubtedly get differing opinions on which implant is best for you so you will have to look at a lot of before and after photos to see what you like best and do as much research as possible.  I would recommend submuscular approach with smooth round Mentor implants.  If you use a tear drop implant I think you will not get enough upper pole fullness.  Seek in person appointments with Board Certified Plastic Surgeons who perform a lot of breast surgery.  Best of luck to you

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.7 out of 5 stars 52 reviews

Subfascial Breast Augmentation. Which implant shape is best for subfascial breast augmentation?

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Based on your photos, anatomic breast implants placed in subfascial pockets versus the use of round implants will still provide you with improvement in upper pole fullness and a natural appearing breast augmentation result. Thanks for sharing your photos and question. Best wishes.

Dr. Gregory Park

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 178 reviews

Subfascial implants?

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If you click on the web reference link below you will see 50 breast augmentation patients, some with saline, most with silicone, most below the muscle, a few above the muscle, but ALL round implants. Read Dr. Minnitti's and Dr. Rand's answers. Just because you saw a few subfascial results that are nice does not make that a "preferred choice." Except maybe for that particular surgeon.

Submuscular implants (smooth, round ones) will give you nice upper pole fullness without an unnatural "Baywatch coconut" appearance, and with the lowest risk of capsular contracture. You want "more volume on the upper pole" but "don't want the implant to show on the upper pole." I'm not sure what you are asking for, but your pretty breasts will have a beautiful result with smooth round cohesive implants whose width (moderate or moderate plus) best fills your base width. You are slim, and above the muscle (subfascial or not) only means that you will have a higher likelihood of capsular contracture and a less natural look in your upper pole area where you have little tissue coverage!

Remember that wider round implants are also taller (since they are round and have identical diameters vertically and horizontally), so this is what I presume you want with more (natural) fullness in the upper poles is breasts that do not look like those Baywatch coconuts. Nothing wrong with that look, just understand that high and round is the province of a good push-up bra and having enough soft breast volume to "push up!"

Plus, you will have a more natural look when reclining, since shaped implants remain teardrop-shaped when you are laying down, whereas normal breasts flatten and round out, like smooth round implants do. Also, those naturally-larger breasts slide slightly to the side of the chest when reclining, something textured implants don't do--they just stick straight up in their place (round or teardrop-shaped). NOT natural.

I'm not saying you can't have a satisfactory result with your plan, just that 1000 women with YOUR plan and 1000 with what I've outlined above will have a decidedly different satisfaction percentage. You guess which! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Subfascial is a Myth

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The subfascial pocket provides neither better tissue coverage nor better protection from the risk of capsular contracture compared to the subglandular pocket.  Unlike some other muscle fascias, the pectoralis major fascia is a whispy thin, translucent layer that easily tears, especially when the implant is inserted. If you believe that it is different in any way from a subglandular pocket, you are being fooled.  There is no scientific data to support it as anything different than a subglandular pocket.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Shaped or round

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It sounds like you have given your surgeon an outline of your goals, they certainly can be achieved by a number of different methods.  In general we do prefer submuscular however, subglandular or subfascial can also produce very good results.  Your breast shape and the volume of enhancement also play a role.  Unless you are getting implants a size of which will take up a majority of the breast volume, shaped implants can give a more natural or less rounded look.  If the volume is less then either a round or shaped can given a very natural look as even round implants take on a somewhat tear drop shape when you are upright.

Subfasial or submuscular and round vs anatomic

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Thank you for the question and as many as there are plastic surgeons you will recieve as many conflicting opinions about your choice.  So I would go on complimentary consultations and become fully informed so you can make an educated decision.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Subfascial breast augmentation

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I think you are making the right choice. You have a very good starting point for silicone anatomical implants in subfascial/subglandular position, and I would agree that they will give you a superior result compared to dual plane or submuscular implants. You are also going with a sensible size, so the problem of implant visibility should not be an issue. Good luck, and I am sure you will be happy with your new breasts!

Ciro Adamo, PhD, MD
Italy Plastic Surgeon
5.0 out of 5 stars 18 reviews

Breast implant choice

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I think you'll find that most all plastic surgeons would recommend submuscular placement rather than subfascial (just a fancy name for above the muscle) placement for many reasons. The moderate profile round implant will give a nice look without a bulgy upper pole.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.