DR. Salzhauer: We have an email from Dee in Miami, and she asks "What is better? Under the muscle, or over the muscle?" I’m assuming that she is talking about breast augmentation. Now breast augmentation, or breast implant, can be done with the implant either placed over or on top of the pectorals Muscle, which is the muscle that you call your pecks, or your chest there. Or it can be placed underneath the muscle. Now 95 percent of the time, it’s much better to put the implant under the muscle. For a number of reasons. First of all, it gives another level of protection between your skin and the implant, so [there's] your skin, your breast subcutaneous tissue, your breast tissue, the muscle, and then the implant. The implant itself is slightly more hidden, so it will make it feel slightly more natural. It also controls the position of the implant. And it keeps it from stretching out your skin and slipping down. Now occasionally, a woman who needs a slight breast lift can benefit from having the augmentation or the implant put on top of the muscle. The only negative to that is over time the skin tends to stretch, and you can get breast sis and require a breast lift sooner than if you’d put it under the muscle. So again, the vast majority of patients in my practice will put the breast implants underneath the muscles. So if you go to your surgeon, and you ask him that question, 95 percent of the time or better you will get the answer that it’s better to put the implant underneath the muscle. And that is regardless of whether the implant is silicone or saline. Silicone implants are back, FDA approved,. They’re great, they’re safe. They feel more natural than saline implants. The only negative with the silicone implant is that they are more expensive, and if you even have to have them replaced they can be a little of a sticky mess in their when the implant comes out when compared to a saline implant. Jeannine: I did my first breast augmentation, I did have over the muscle. And of course had problems with them, because after so many years they just sagged tremendously. And when we did them last time, we did go under the muscle, and what a difference it was! I mean, I don’t even know that many surgeons that do them over the muscle anymore. Very seldom. Dr. Salzhauer: I think I’ve done it one out of a hundred or less, or one or two out of a hundred.

This entry was posted on Sunday, April 29th, 2007 at 11:00 am and is filed under Breast Augmentaiton, Breast Implants, Muscles. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.