Breast implants: Subglandular VS. Submuscular? (Photo)

Hello,Your Plastic Surgeon will definitely be the best one to advise you about placement. Part of your in-person consultation involves taking careful measurements of your breasts and assessing your existing breast tissue. These factors plus your lifestyle/aesthetic goals will influence how they advise you.All the best

Hello, when making recommendations about the best implant pocket for a particular patient, the surgeon takes into consideration the amount of breast tissue, skin tone, nipple position, and other factors.  You would need a proper assessment to get proper advice about the best pocket for you.

Good afternoon!Your best result will be with a Mod Plus or High
Profile round smooth
silicone gel implant placed under the muscle! Lasts longer, looks better, feels better, lower complication rates, better mammograms, etc etcI have attached a link to my Breast Augmentation photo gallery for your review- hope it helps!

Suglandular implants are not perky!!!!!There are
many advantages to sub muscular dual plane placement and very many
disadvantages to sub glandular placement. I would see no indication to do
anything but sub muscular. This can be best accomplished with the armpit
approach. The most sophisticated approach to breast augmentation is through the
armpit with a surgical camera (transaxillary endoscopic). Using this modern
approach the space can be crafted under direct vision, with virtually no
bleeding and no postoperative bruising. Most importantly, the shape of the
breast is meticulously created. The other, older methods of insertion are
technologically less advanced. Both silicone and saline implants can be placed
through the armpit by a surgeon with skill and experience using this approach.
The incision in the crease is the oldest method of placing the implants and
puts a scar directly on the breast.

Subglandular
silicone implant placement is the historical approach to this surgery, and was
widely used in the 1960's. The implant edges are more visible, the risk of
rippling is higher, the implant is in contact with the non-sterile breast
tissue so the risk of infection and capsular contracture is higher. The
interface between the breast tissue and the muscle is blurred so the implant interferes
with mammography more than sub muscular placement. The blood supply surrounding
the implant is worse so the risk of capsular contracture is higher. The support
for the implant is less so there is more long term shape abnormalities and
sagging. The look of a sub glandular implant is much less appealing than a sub
muscular implant. The placement of sub glandular implants makes any subsequent
revision surgeries more complicated and less successful. There are no
advantages to sub glandular implant placement.

In general, most patients get implants placed sub muscularly. The reality is, the most common, and in my opinion, best way to do it is partial sub muscular. You have the benefit of muscular coverage of the implants on top, preventing the "ridiculous circle" look, and sub glandular below, allowing for more perky and natural look with pretty roundness at the bottom of the breast. I feel that this is the case in most of the images you've shown, and I feel that that would be your best option. Of course, it is very important to have an in person examination to determine that for sure. It is imperative
that you seek the advice of a plastic surgeon who is certified by the American
Board of Plastic Surgery and has extensive experience in breast augmentation.

I wish you the best.

Dr. Gabbay.

Thank you for your questions and photos, and I wish you the best of luck
with your decision. It is best to see a Board Certified Plastic Surgeon who can
in person examine you, take key measurements and go over with you your specific
aesthetic goals. My consultation is done at no charge, and is meant to help you
start getting the best aesthetic result. Also included is a review and
discussion about the actual implant differences, placement, incisions and post
surgery recovery process.As you
probably already have read, there are
several key differences and some similarities in the types and shapes of breast
implants as well as the location of the implant placement. It is best to talk
in consultation with a Board Certified Plastic Surgeon.
Benjamin J. Cousins M.D.
Board Certified Plastic Surgeon

Thank you for the question. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”. The vast majority of breast implants placed in the "sub muscular" position are really being placed in the "dual plane" position ( partially sub muscular, partially sub glandular). I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or 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 breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.On the other hand, sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle) they can be seen with breast implants placed in the sub muscular position. Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup” or "perky boobs" etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.

 Your photos are very difficult to assess. However it appears that you have a certain amount  of sagging. This may be important in your desire for perky breasts  The last thing you would want is a subglandular implant. There is no support for these and they fall very quickly giving you a rock in a sock look  implants under the muscle by far are the best. Silicone implants are also the best choice for maintaining position.    You should schedule an appointment with a board certified plastic surgeon with experience in breast augmentation and lift. He can best assess your needs to give you the best and most perky breast