Would I need a lift for OTM implants? Is UTM a better option if I don't want a lift? (Photos)

Question

I am considering implants however after research, I feel like over the muscle has more benefits and would give me the look I want at a smaller size. Looking at my images, would I need a lift for OTM? Would UTM be a better option for me if I needed a lift and didn't want one?

Jeffrey M. Darrow, MD · Answer

Thank you for your photos. Your nipple/areola and all of your breast tissue is positioned above the fold underneath your breasts.  This is the aesthetically correct position.   Whether you place your implant over the muscle or under the muscle, you will end up with an enhanced version of your current breasts and therefore, there is no reason to have a breast lift.  A lift would not benefit you and would place unnecessary incisions on your breast. Discuss this in detail with your plastic surgeon. Best wishes.

Brian K. Reedy, MD · Answer

Thanks for your question! I think you would be a great candidate for OTM with Motiva's implants if you don't get too greedy with size. You definitely do not need a lift. I would suggest finding a board-certified plastic surgeon in your area to achieve optimal results. Good luck!

Donovan Rosas, MD · Answer

When undergoing breast augmentation there are a number of choices which need to be made: saline or silicone? Volume: Larger or smaller? Incision? However, one of the most commonly debated choices is that of implants placement: subglandular/ submammary vs. subpectoral/ submuscular? While many surgeons recommend submuscular placement there are distinct differences to each approach.

Subglandular Augmentation (“overs”):

•	Subglandular augmentation means place of the implant underneath the breast tissue but above the pectoralis muscle. Subglandular placement spares the pectoralis muscle which leads to reduced post operative pain/discomfort and no impact on muscle function post augmentation. Recovery is also faster 
when compared to subpectoral augmentation.

•	Subglandular augmentation can impact mammographic evaluation of the breast. However, as dedicated breast radiography has become more prevalent this has become less of an issue. Fellowship trained radiologists have become familiar with evaluating breasts post augmentation. It is also important to note that implant position does not interfere with visualization of breast tissue via contrast enhanced MRI (the most sensitive and specific study available for breast cancer detection).

•	Studies suggest there is an increased risk of capsular contracture when implants are placed in a subglandular space.

•	Aesthetically, implants placed superficial to the pectoralis major create a rounded, convex appearing breast profile. This effect is camouflaged, at least initially in larger breasted patients. However, as a woman ages fat atrophies and breast tissue descends. The result is a more noticeable implant specifically in the upper pole. Similarly, patients who have thin coverage superiorly are more likely to be able to perceive the implants and at higher risk of visible rippling.

Subpectoral Augmentation (“unders”):

•	Subpectoral augmentation is technically a bit of a misnomer. Traditionally, subpectoral augmentation involves the release of the pecotralis major muscle from its lower attachments. This allows the muscle to “window-shade.” The upper hemisphere of the implant sits underneath the muscle (dual plane). This release contributes much of the discomfort encountered postoperatively by patients.

•	Subpectoral implants have a lower rate of capsular contracture.

•	Aesthetically, in contrast to submammary implants (which are prominent in the upper pole- especially in thinner patients), the pectoralis muscle both conceals the underlying implant and flattens the upper pole. This flattening effect creates a natural sloping as one proceeds from the upper portion of the implant to the lower portion.

•	The most commonly cited drawback to sub-muscular augmentation is the animation deformity associated with contraction of the overlying muscle.

Each approach has both costs and benefits. Patients are unique and so too is each operative plan. A potential augmentation candidate may be better suited for one approach or the other.

Based on your photos, you do not appear to need a lift. The NAC appears to be sitting well above the fold.

As always, your board certified plastic surgeon can help guide you in your decision making process.

Would I need a lift for OTM implants? Is UTM a better option if I don't want a lift? (Photos)

Answers (3)

More Breast Augmentation Questions

Mentor Boost vs Sientra vs Motiva – which is best for cleavage + upper fullness? (Photos)

Implants without a lift - is this recommended for my current anatomy? (Photos)

61, 5'2", 129 pounds - Saline submuscular implant capsular contracture softening or deflated? (Photos)

Considering Breast Aug/lift Revision - Would A Different Profile Offer More Base Diameter? (Photos)

Asymmetry concern - how can this be fixed? (Photos)

Can silicone implants last 40 years or more?

WE SEND PRETTY
EMAILS