Hi, It’s Dr. Mabourakh from Folsom Plastic Surgery. This is one of our series where we answer questions that we received from patients, and today’s question is?
The best way to do an augmentation with implants is to place them under the muscle. Why?
Under the muscle gives you more protection for the implant, there’s less visibility, it does reduce the risk of capsular contracture, where the implants become firm. Slightly rather than on top of the muscle, and over time there’s more support for the implants especially for a larger implant to avoid sagginess.
What are the times that we can put the implant under the muscle.
Well if you look at the patient right here (see video) there’s no sagginess, the breast are in good position there’s no problem placing an implant for her under the muscle. When we get into a patient who has some sagginess little bit of ptosis where their breasts have dropped what we look at is position of the nipple to the infirmary fold, so when the nipple is below the fold if you put an implant under the muscle it’s not going to look right. The implant stays high and the breast stays low in that case, we have two options:
We can put implants on top of the muscle therefore now the implant doesn’t stay high it drops where the breast is, and you give her a natural looking breast.
Or if you want the implant under the muscle, then we must perform a breast lift. A lift brings the breast back up into position, so it’s riding on top of the implant and the positioning works.
Now, the disadvantage of putting the implant on top of the muscle, well again you see the implant more especially on saline implants a lot of rippling is visible, more saggy over time, and if the implants are larger they do tend to pull the breast down much faster.
Otherwise underneath the muscle, now we have to do a lift and adds additional scars. There are different kinds of lifts that are for another discussion but that’s the thinking behind under the muscle versus over the muscle.
Well, I hope that was informative. If you have any questions, please contact us.
If you have any questions you want me to answer, just let us know, we’ll be happy to do that online.
Thanks for watching.
