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Good question. We go into great detail addressing this issue in our “Girlfriend’s Guide to Breast Augmentation”, but here’s the abbreviated version. Choose the submuscular (under the muscle) placement if you have saline implants, a small amount of natural breast tissue or a strong family history of breast cancer. Choose the subglandular (over the muscle) placement if you want silicone implants, have a large amount of natural tissue with saline implants or require a breast lift. Also, keep in mind in some women either placement is a good option. Learn more in Dr. Reath’s Blog:
Whether you choose to have your implants over or under the muscle may impact your recovery by a day or so. Either way, most of the women we see for breast augmentation, who come to our practice from the Knoxville area, Johnson City, Cookeville, Cleveland, and beyond, are able to return to normal activities in 7 to 10 days and usually need no more than a week off from work.
One idea that typically works well is to have your surgery on a Thursday and take the next week off work. That way, you can easily go back early if you’re feeling up to it, but you don’t feel pressured to go back before you’re ready.
Another thing to keep in mind is how physical your job and normal activities are. A good guideline is not to lift anything, and certainly nothing heavier than a gallon of milk, for the first week after surgery. If you have small children running around or your work involves heavy lifting, you may need to have more help during your recovery or more time off.
Our eBook “The Plastic Surgery Planner” is a wealth of information on recovering from surgery. You can download it here.
Plastic Surgery Planner
Tips to Manage a Speedy Recovery
A good general guideline is that you can start slowly (walking) after a week and work up to more aerobic activity as you feel comfortable. For chest presses and weight lifting, you should give it at least two weeks (you won’t feel like doing it anyway!) It will be longer if your implants are placed under the muscle.
There are three companies that produce breast implants in the United States. Mentor, which is a subsidiary of Johnson and Johnson, Sientra and Allergan. Both implant brands are excellent, and most doctors choose implant companies based on their service, which is why Dr. Reath uses Allergan implants. Although implant brands may matter a lot to your surgeon, they probably won’t mean that much to you unless you need to replace implants under warranty. That’s why most surgeons will have a good relationship with all three breast implant companies in order to best take care of their patients.
Round implants are totally symmetric so that their orientation, when placed, is never a problem. Anatomic or teardrop implants, on the other hand, are asymmetric. There is greater projection at the bottom of the implants than at the top. They have a tendency to rotate causing problems. So, round implants are definitely the most commonly used implants. They look more natural when you are standing up and lying down. Plus they are less expensive.
Here’s a good way you can tell. Standing in front of a mirror, look at your nipples in relation to the natural crease beneath your breasts. If your nipples are lower than your breast crease before surgery, adding implants without removing excess skin will make them more saggy. And it will just get worse with gravity over time. Sad, but true. You will probably need a lift. If your surgeon tells you to just use bigger implants, don’t go there girlfriend!
As women, we tend to think in cup sizes because that is how we buy our bras. The most common comment we hear from women is, “I’d like to be a C-cup?”. When we hear that we translate it to mean, “She wants her breasts to look like they fit the rest of her body.” This is because cup size is a very subjective measurement. Everyone wears their bras differently and every bra manufacturer makes them differently. You may be a 36C in one bra and a 34D in another. And when you check out all the different styles at your local Victoria’s Secret, you can understand why we say think proportion and shape, not cup size.
Many people are under the mistaken impression that breast implants need to be replaced every five years, seven years, ten years (kind of like you should get your oil changed every 3,000 miles.) However, this is not true. Basically, if you are not having any problems with your implants, there is no need to replace them. In case you’re wondering, the most common reason implants are replaced is when a woman wants to change her size.
Dr. Reath goes into more detail about the longevity of breast implants in the video below.
Maybe, but it’s important to understand before your surgery that increasing the size of your breasts is not what gives you cleavage. Cleavage is a function of the shape and width of your chest and how close your breasts are together. Remember when you were little a little girl and you would cross your arms to pretend you had cleavage? It’s the same principal here. If your breasts are set wide on your chest, you will have more fullness after your augmentation, but not more cleavage. Conversely, if your body is narrow below your shoulders and your breasts are close together, you’ll have great cleavage even with a small implant.
Dr. Reath always uses smooth implants. He explains, “I definitely prefer smooth implants. It was originally thought that texturing implants would lead to a softer result with less capsular formation. However, this has not been borne out clinically. Textured implants adhere to the surrounding tissues and do not move as well with massage. Additionally, rippling is much more common with implant texturing.”