Breast Augmentation. Would above the muscle be an option for me?
Doctor Answers 17
Above the muscle or beneath the muscle placement of implants have distinct benefits and risks.
Of course, without examining you, I can not give you definitive recommendations for the position of placement of your implants. In truly athletic patients with large pectoralis major muscles and reasonable size expectations, I usually suggest the use of textured gel implants in front of the muscle.
Subglandular positioning of small implants with adequate breast tissue coverage can provide aesthetically pleasing results with less post-surgical pain and a quicker recover for lean athletic patients. The risk of visible breast surface distortion with pec. major contraction is avoided as is the risk of a double bubble deformity.
The placement of your implants should be discussed with your experienced cosmetic plastic surgeon(s) in consultation...
Breast augmentation over the muscle for athletic women
Above the muscle??
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Breast Augmentation Above the Muscle...?
1. Implants above the muscle add more weight to your breast which is supported only by your skin and will add to the tendency to droop.
2. Capsular Contracture (Breast Implant hardening) rates are much higher above the muscle than under the muscle.
3. Most importantly, Cancer detection on mammograms is better with the implant under the muscle.
4. There are many other reasons why under the muscle is better.... less palpability of the implant, less visibility of folds and ripples, better superior pole fullness, lower risk of synmastia (uniBoob)
You can never choose your surgery by someone else's results. All breasts are different!
Breasts implants pocket location and implants size selection
- Dear Tb,
Thanks for submitting your pictures.
From observing your pictures , you appear to have nice and perky breasts with wide cleavage and your size looks like small A cup.
I have been in practice for 29 years and performed breasts augmentation with implants on many athletes. The most common size selected by these patients was full B cup size or small C cup size, which makes sense due to their intense sport activity.
In regard to implants size selection, you did not provide your chest circumference in inches, which is critical for the correct implants size selection. Let's assume that you are currently 34 small A cup size. To become 34 small C cup size, you will need implants with volume of 300 cc.
I place the implants through a sub areola incision as oppose to sub mammary fold , because the scar is friendlier and this entry allows for pocket dissection under direct vision and feel, which creates beautiful cleavage, symmetrical breasts and precise fold.
As far as pocket location, there is a reason why most surgeons in the US place the implants under the pectoral muscles.
Here are the reasons:
1. Much less loss of nipple sensation, because the nerves are crossing above the muscle, exactly where the pocket is made with the above the muscle technique.
2. Better coverage of the implants, especially importants in thin peoples like yourself.
3. Statistically, less capsule contracture.
4. Less hematomas, because the pocket under the muscle is almost bloodless, unlike the other technique.
Finally, one bird does not bring the spring and your one friend's nice outcome is insufficient to make a judgement. You have to do a good due diligence and choose wisely.
Always, consult with experience board certified plastic surgeons who do lots of breasts augmentation surgery in accredited surgery center for your safety. Most importantly, check the before and after picture in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky , symmetrical and natural looking. Also, check the 'Realself' reviews for rating and positive experience reports.
Best of luck,
Breast Augmentation. Would above the muscle be an option for me?
Subglandular implant benefits:
- A shorter recovery time.
- Less discomfort initially.
- No distortion of the breast when the pectoralis muscle flexes.
- Mild preoperative sagging can be improved, especially if no breast lifting procedure is performed.
- Easier surgical procedure.
- Larger implants can be placed.
- The implant may be more visible.
- More visible rippling, especially in patients with a small amount of natural breast tissue.
- Generally, saline implants do not produce a good result in front of the muscle.
- Higher incidence of capsular contraction.
- “Bottoming out” in some patients.
- Some radiologists have more problems reading a mammogram with an implant in front of the muscle.
- Usually results in a better appearance for naturally small breasted women
- Less tendency for seeing ripples of the implant.
- A more natural feel to the breast especially in slender women who don’t have much of their own breast tissue.
- Less interference with mammograms, although most radiologists take additional views no matter where the implants are placed.
- Lower rate of capsular contraction.
- Less of a chance of “bottoming out” where the implant bulges at the lower aspect of the breast and the nipple and areolas tend to appear excessively elevated.
- Recovery usually takes a little longer and is more uncomfortable initially.
- There may be an “animation deformity”, which is a temporary distortion of the breasts when the pectoralis muscle is flexed. Body builders and weight lifters generally prefer implants in front of the muscle.
- It is harder to achieve cleavage in women who have widely spaced breasts.
- The implants often ride higher on the chest.
The ideal placement in any particular patient depends on their particular anatomy and understanding of the pros and cons of each approach.
Keep in mind, that following the advice from a surgeon on this or any other website who proposes to tell you what to do based on two dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure may not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with or if you plan to have the surgery in Australia, the surgeon should ideally be a member of the International Society of Aesthetic Plastic Surgery (ISAPS). You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
Yes you can
Plastic surgery is not risk free, regardless of the implant you select, the pocket placement, or the plastic surgeon you select to perform your surgery. An experienced board certified plastic surgeon will review all of your options with you. Make sure that you are consulting with a plastic surgeon whose aesthetics align with yours. And make sure that you communicate your visual endpoint with photos, not just with words like "natural", proportionate", "not too big", because all of these descriptions are notoriously subjective and inexact. Also, if you are not confident after your first consultation, don;t hesitate to schedule a second or even third. It is much easier and less expensive to do your due diligence ahead of time than to be disappointed with your outcome and undergo revision surgery. Best of luck to you.
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.