During the last decade and beyond, more and more breast implant surgeons are placing breast implants on top zof the muscle rather than underneath. The only reason we can guess as to why this is happening is that more surgeons are getting lazy! Other than that, implants placed on top of the muscle can usually be done significantly cheaper than placing the implants under the breast muscle.

Sub-glandular (under the breast glandular tissue, but on top of the muscle) is a much simpler, much shorter operation requiring less surgical skill. Additionally, sub-glandular breast augmentation can be performed in the surgeon’s back office under local anesthesia instead of in a surgery center or hospital the initial results are usually OK for the first few years after surgery, but that is when problems can develop.

Implants placed under the muscle offer several, very important advantages to those placed on top of the muscle. In the short-term, sub-muscular implants provide a better appearance by hiding implant rippling, especially in very thin women. The rate of breast implant hardness, known as capsular contracture, is significantly decreased. Most importantly, placement of the implants under the muscle causes the muscle to act as an internal bra, holding the implants up in a higher, more youthful position.

But the biggest problem is yet to come. All women’s breasts will become droopy as the woman ages. If the breast implants were initially placed on top of the muscle, the breast tissue will age much faster, creating droopy breasts that will undoubtedly need to be lifted later in life. Remember, bigger breasts with implants placed on top of the muscle will age just like larger natural breasts would have, had the woman grown larger breasts in her teenage years and not needed implant surgery.

The problem with breast implants “On Top” of the muscle.

Serious complications can occur when a woman finds she needs a breast lift after having breast implants originally placed on top the muscle. When the original breast surgeon created the pockets on top of the breast muscle, he or she had to cut the blood vessels going to the breast tissue and overlying breast skin, since the blood vessels are in the way when the pockets are created. This is not a problem at the time of the original operation because there is adequate blood supply coming from the skin and tissue at the edges of the breast pocket to supply the nipple with blood and oxygen.

If, however, you want to have a breast lift later, there is usually not enough reserve blood supply coming from the edges of the pocket to supply adequate oxygen to heal the incisions in the breast tissue and skin adequately after a breast lift operation. This problem can sometimes cause the nipple and surrounding breast tissue to suffer inadequate blood supply and oxygen deprivation during the immediate healing stage, resulting in the nipple and surrounding tissue dying within a few days after the breast lift operation. This is an extremely difficult complication to treat and may require skin grafts to the breast and nipple with a poor cosmetic outcome at best. The only safe way to proceed, with a breast lift after breast implant placement on top of the muscle, is to first remove the implants altogether. This will allow the blood vessels to hopefully grow back into the underside of the breast tissue as the implant pocket collapses after removal of the implants. Six months later the woman can have new implants placed under the breast muscle and a breast lift performed at the same time.

If you are considering breast implant surgery at all, speak with your surgeon in detail before surgery and strongly consider having him or her place your implants under the muscle to begin with. In the long term you will be much, much happier. For questions about breast implants and potential complications or problems, contact Ronald Moser, M.D. at Aestheticare Cosmetic Surgery Centers, 1-800-662-1055. AesthetiCare Cosmetic Surgery Institute, in practice for more than 21 years, Orange County Cosmetic Surgeon Dr. Moser and Dr. Kane specialize in Orange County Breast Surgery Revision, Newport Beach Breast Augmentation, Riverside Liposuction and other plastic surgery procedures of the face, body, breast and other. AesthetiCare can be contacted directly via their website at aestheticare.com or by calling 1-800-662-1055 from within the United States or 1-949-661-1700 from outside the United States.

Contact Aestheti Care

AesthetiCare Orange County

30260 Rancho Viejo Rd. San Juan Capistrano, CA 92675

Phone: 949-661-1700

Web: www.aestheticare.com