Subglandular or Submuscular? (photo)

I'm 36 years old at 150lbs looking to do a Breast augmentation. I'm trying to figure out which is best for me either subglandular or submuscular. One breast is an B and the is a C- looking to do a full C/small D. Going through the nipple with silicone- 400cc and the other is 450cc. I'm just not sure what is best one is a little saggy but not complete ptosis, where I still have enough breast tissue for subglandular. Which is best? Help...

Doctor Answers 9

Subglandular or Submuscular?

The options are more than you ask! Sub pectoral, sub glandular, dual plane as for placement. Size differences of the implant. And a possible lifting. So you see your issues need in person evaluations NOT over internet! Best to seek additional in person consults from boarded PSs in your city. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Subglandular implants are not recommended

Thank you for your photo.

Allow me to be blunt. Subglandular implants that size (400-450cc) are too heavy and will stretch your skin necessitating a lift in no time. I recommend you follow the breast augmentation blog on this site and follow patients stories that have had subglandular implants.  Asymmetry is easy to fix by placing different size implants. Both breasts need a lift. One way to lift them without a vertical scar is to employ the Mini Ultimate Breast Lift. An incision is made around the areola and a strapping technique is used to lift and re-arrange your breast tissue to maximize the lift. Remember, beautiful breasts are not defined by size. Shape, symmetry, and height do.

Kind regards,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews


It appears you have a fair amount of asymmetry.  You have a moderate amount of breast tissue so a subfascial or submuscular approach is possible.  I would discuss the pros and cons with your surgeon.  On the right side I would recommend a lift with resection of some breast tissue in addition to the implant.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.7 out of 5 stars 35 reviews

Breast augmentation

I think that a breast augmentation is reasonable, but I think that a small lift on the low side may be reasonble as well.  Best to be seen in person.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Subglandular or Submuscular?

Very complicate, the breasts are with different size, but the areola are different height, try to modified at list the height of right areola.


Spanish translation provided by doctor:

Muy complicado, las mamas son de diferente tamano, pero las areolas estan a diferente altura, traten de modificar por lo menos la altura de la areola derecha.   

Maria Cristina Picon, MD
Argentina Plastic Surgeon

Subglandular placement of implants

Thank you for the question and the photo.

The photo shows that you have an asymmetry. This could be managed by using different size implants and since you are going through the areola maybe an areolar lift on the bigger breast.

Subglandular placement is a good option for you.

Best of luck...

Dana Khuthaila, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 68 reviews

Cosmetic Surgery is an Art and a Science

Thank you for your question. Your breasts are asymmetric which complicates your decision. You may need different size implant to correct. They can be placed above the muscle in you case. Best Wishes Thomas Narsete, M.D. Austin, Tx

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews


Normal breasts are above the muscles and that's where you need your implants. This is always controvertial, I have been doing implants over 30 years and believe that for you they should go over the muscle.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Subglandular or Submuscular?

My personal preference would be for submuscular placement, particularly with the size implants you have chosen. 

At least as important is consideration of a breast lift, at least on the right, probably on both. An implant without a lift may result in the unsatisfying appearance of the breast tissue draping off the implants. Discuss the pros and cons with your surgeon before the day of surgery. Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.