Subglandular vs. Submuscular with Lift Breast Augmentation?

I have seen my PS and I have a date scheduled 5 months from now for subglandular breast implants because I have a droop. But he gave me two options, this option or getting a Breast lift and submuscular Breast augmentation. I am rethinking and may choose the lift with submuscular. I just want something that will be better for me in the long run with less complications than the other and not necessarily faster healing but better healing. It is my first augmentation and I am 33 year old with one baby possibly 1 more. What are your opinions?

Doctor Answers 14

Breast lift and Augmentation

Your question is very hard to answer. Usually, if one needs a lift, one needs a lift. There are, however, several methods of doing lifts. In addition, the implant itself, if large enough, can correct some droop. The question of position is a wholly different matter. If I am trying to get any lift with the implant or am doing a lift at the time of augmentation, I never place the implant below the muscle. The reason is simple; by dissection on top of the muscle I free the breast to move up. This does not happen with a sub muscular implant.

Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Sub muscular vs Sub Glandular placement

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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Implants without lift

You may not need a breast lift, however to determine this you would need a consultation with a surgeon who has experience with performing breast augmentation on breasts affected by mild to moderate sagging. You can consider Allergan Inspira Truform 2 implants with a narrower base width for more projection.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Lift vs subglandular implant

Subglandular placement always look good right away, but the weight of the implant will further stress your tissue over time, and result in breasts that hang even lower.  Submuscular breast implants with a lift, will likely result in a more favorable long-term result. 

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 168 reviews

Breast Augmentation/Breast Lift Implant Positioning?

Thank you for the question.
In general, I think it is in your best interests (and that of most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).
The submuscular positioning  also tends to interfere with mammography less so than in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Subglandular breast augmentation or submuscular augmentation and lift

If you have minimal ptosis (or sagging) of your breast, a subglandular placement might give a nice result with fewer scar lines or incision lines. However, your mammogram may be adversely affected by going with a subglandular implant--although in my experience your physical examination would not be adversely affected.

If you have significant sag then I would typically recommend a submuscular implant with a complete breast lift, though you will have more scars. It's difficult for me to say for certain without having seen you myself, as everyone's body is different.

Deason Dunagan, MD
Huntsville Plastic Surgeon
4.9 out of 5 stars 12 reviews

Submuscular Augmentation with or without a lift

The submuscular placement of the implant offers clear advantages whether an augmentation alone or a mastopexy-augmentation is performed. The key to the success of an aesthetic appearing breast is having the implant covered by as much tissue as possible. When an augmentation is performed in a patient with ptosis (sagging), the upper pole of the breast usually has very little tissue to cover the implant (this part of the chest is usually flat and usually one of the reasons the patient seeks augmentation in the first place). If an augmentation is performed on top of the muscle, a long term unnatural appearance in the upper pole can occur. If the implant is placed under the muscle, the upper pole of the implant is now covered by the muscle resulting in a more natural appearance.

Placing the implant under the muscle in a breast with sagging is performed by creating a bi-planar or dual-planar dissection. I prefer to do this through a hidden armpit incision.

I usually recommend to my patients choosing an augmentation or a mastopexy-augmentation based on the look they choose to have following the procedure: not based on implant location. Several factors must be evaluated: scars, shape to the breast, size, etc. But in my opinion, the patients desire for the shape of the breast is the key component to the choice of the procedure.

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.5 out of 5 stars 25 reviews

Breast lift with submuscular implants is a better choice

The choice of submuscular implants with a lift is a better choice that subglandular implants without a lift. There is no comparison long term between these two. The subglandular option will eventually look like a ball in sock possibly and won't give you much of a lift at all. The submuscular implant doesn't have to be bigger than you want and the lift will reshape the breast, tighten the skin and elevate the nipple areola to a youthful posiiton.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast lift vs implant position

Your situation is not uncommon and there is no right answer. None of the options is ideal. If you just put in implants you will still have some drooping but less scarring. If you do a lift and implants you have much more scarring but markedly improve the drooping f the breast.

I suggest you look at photos of each adn se what you might prefer.

Either way there is a high chance of additional surgery in your future to revise what has beed done.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

When in doubt, do a breast lift with breast implants.


Cannot give you specific advice because everything depends on the details of your anatomy, but the mere fact that the topic came up usually means that you will do better with a breast lift with breast implants.

Women accept the scars very well if they love their new breasts. Some surgeons are afraid to recommend breast lift because they are afraid of scaring the patient.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

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.