Got a Subglandular Implant... Went in for Submuscular - Is This Going to Be Bad?

I just recently had surgery for Breast Aug. (two days ago). We had decided to go with smooth, round, high- profile saline, submuscular implants. I was a very small "A" size cup and wanted to go to a "C". I am a rather thin girl weighing only 115 lbs and stand 5'7" tall. Well, I get into the operating room and my doctor tells me that after looking closer that he thinks that we should go sub-glandular. We did, now I am nervous for dropping and rippling because of my size.. should I be?

Doctor Answers 11

Over implants

It is difficult to say what you may achieve without an exam. But yes, you are more prone to rippling in overs especially if you are very thin.  Drooping is dependent upon your skin quality and the size of the implants.


New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

Over or Under?

Well,  as a generality in women who are A cup breasts I place the implants beneath the muscle.  My reasoning is that in the upper part of the A cup breast the tissue tends to be thin so I would like to mask the imperfections of the upper portion of the implant .  In your case wait several months to see your final outcome and if there are issues at that time then get these addressed.

Good Luck

Dr. ES

Wait

You just had surgery and it is too early to start worrying about the rippling and sagging. I guess  the size you wanted was too big to go submusclar  and your surgeon decided to go subglsndulsr.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 104 reviews

Deciding on subglandular or submuscular breast implants

There are a number of considerations when deciding upon whether to place saline implants under the pectoralis major muscle (submuscular) or immediately under the breast tissue itself (subglandular). The appearance and risk of certain complications, such as capsular contracture, are different with each. All of these factors are apparent prior to surgery and the decision on implant placement should be made after careful evaluation and discussion with the patient during a pre-operative consultation.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

No Explanation for "going subglandular vs. submuscular" in breast Augmentation

Regarding: "recently had surgery for Breast Aug. (two days ago). We had decided to go with smooth, round, high- profile saline, submuscular implants. I was a very small "A" size cup and wanted to go to a "C". I am a rather thin girl weighing only 115 lbs and stand 5'7" tall. Well, I get into the operating room and my doctor tells me that after looking closer that he thinks that we should go sub-glandular. We did, now I am nervous for dropping and rippling because of my size.. "

I agree with both my colleagues Drs. Placik and Rand, and fell EXACTLY the way Dr. Rand feels. I would discuss this with your surgeon but I cannot explain what possibly could have made him choose to put these implants in a more exposed, less covered plane.

Dr. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 97 reviews

Implants placed under or over.

High profile saline implants tend to have the least amount of rippling of the saline implants. Clearly, it doesn't make sense to take you back at this time and I would relate your concerns to your surgeon.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 72 reviews

Submuscular vs subglandular breast implants - when should the choice be made?

While I wasn't there, I would say two things about your question.  First of all I always go submuscular, especially in a thin patient in whom I am using saline.  This is to minimize the wrinkles and to not have to overfill the implants so much that they become hard feeling.

The second is that to change the plan in the OR after "looking closer" doesn't impress me quite frankly with the doctor's organization or experience level.  In my opinion, those decisions need to be made at the time of your preop visit (2 weeks before in my practice) so there are no surprises like this.  For an entirely elective procedure, last second decisions are not good and only set you up for the doubts you now have.

Dropping of your implant

Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity.

Breast implants initially after surgery when placed in a submuscular position often give superior fullness that corrects itself with time, the "fluff and drop" phenomena. In reality the pectoralis major muscle takes a while to adjust its size to accommodate the implant as well as occasional muscle spasm which keeps the implant projection higher than its final resting shape. Additional variables include:laxity of skin, size difference during prior pregnancies, position of implant,size of muscle, and size of implant.
As the muscle relaxes the projection of the implant often increases and the breast shape improves. Massage and use of a superior placed elastic strap can often make this process go faster.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 119 reviews

Sub-glandular breast implants can look beautiful and not cause problems

Thank you for your question. Most plastic surgeons today prefer to place breast implants beneath the chest muscle. However in some patients the implants are placed beneath the breast gland for a variety of reasons.

Be aware that 100s of thousands of women over the past 60 years have had implants placed beneath the breast on top of the muscle, have a beautiful result and do not have problems.

Subglandular

I don't understand why the plan would be changed w/o discussion, but hopefully you will be fine. Discuss options for rippling if it occurs with your surgeon on your next visit. You may well be fine and have no problems.

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.