Mammogram with over the muscle implants?

Question

I am 32, C cup, 190lb , 5'11. I am currently scheduled for my augmentation in a month but am worrying about having my implants over the muscle. My surgeon has examined me and said since I have ample tissue in the bottom of my breasts that to get a fuller look like I want she would go over the muscle. 450-500 cc's is what I'm debating. So my question is how hard is it to get a mammogram if my implants are over the muscle?

Donovan Rosas, MD · Answer

Patients who have had breast augmentation can safely undergo mammogram irrespective of the implant position (over/under the muscle). The presence of an implant causes an insignificant drop in diagnostic sensitivity. Most dedicated breast radiologists have become accustomed to evaluating patients post augmentation. However, they do typically prefer sub-muscular placement.As always, discuss your concerns with a board certified plastic surgeon.

Gerald Minniti, MD, FACS · Answer

Hello,Breast implants cause a minor diminution of mammogram sensitivity, whether over or under the muscle. It is generally felt by radiologists that subpectoral implants create less of a problem. Based on your height, weight, and bra size, I wonder if you are a candidate for a breast lift.  Frequently, surgeons recommend implant placement over the muscle in women who probably need a lift. Be certain that you choose an ABPS certified/ASAPS member surgeon that specializes in all forms of cosmetic breast surgery, not just implants. Best of luck!

Paul J. Leahy, MD · Answer

Thank you for your excellent question. Data that I've seen do not find any difference in detecting breast cancer with implants above or below the muscle. However, that is still debated, and some radiologists have said it is a bit easier to find and localize breast disease when implants are under the muscle. As long as you are getting regularly-scheduled mammograms, and keep up w/ self breast examination, you should feel safe either way you choose. Best wishes.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well... If you surgeon recommended you that you need to have them under the muscle, then do what your surgeon recommends, if your breasts have sagginess, it is better to have them with subglandular placement..

William H. Gorman, MD (retired) · Answer

This is a good question, but one that is debatable. Some Radiologist I have spoken to say it doesn't matter if an implant is above or below the muscle in terms of interpreting mammograms. Others say that interpretation is easier when the implants are under the muscle. It seems to me that having the muscle between the implant and the breast tissue could make it easier to see exactly where the breast tissue begins. There are enough good reasons for going under the muscle that 95% of the time I place silicone gel implants in the sub-muscular pocket. There are exceptions and if you trust your surgeon, and he or she is a board certified plastic surgeon, then you should follow their advice. If not sure, get a second or third opinion.

Jay M. Pensler, MD - Account Suspended · Answer

You can certainly obtain a mammogram with implants that are either above or below the muscle.The biggest difference between the two approaches is the appearance after surgery which you should investigate a bit more thoroughly.

Brooke R. Seckel, MD, FACS (retired) · Answer

Generally speaking placing implants under the muscle with lesser risk of capsular contracture and possibly displacement of more of the lateral breast tissue forward provides better mammograms than subglandular implants. You are considering rather large implants and my concern is the risk of capsular contracture, thinning of the breast tissue with more visibility of the implant with time and palpability of the implant.

Mammogram with over the muscle implants?

Answers (7)

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