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For many reasons, I have always been a strong proponent of placing breast implants behind the muscle (submuscular) versus in front(submammary) in breast augmentation surgery. These include better support and soft tissue coverage of the implants, lower risk of capsular contracture developing, a softer and more natural overall appearance and feel. An even more important reason is that the breasts can be better assessed on mammography when the implants are situated behind the muscle rather than in front.

Rarely, will I ever place breast implants above the muscle and when I do, it is usually as an exchange for someone who has had reasonable results with their implants situated in this location. Body builders are another exception.

It is amazing to me that there are still many physicians who place a majority of their patients’ implants in a submammary pocket. Many of these happen to be non-plastic surgeons who find that performing the procedure is easier this way and therefore dismiss or ignore important aesthetic issues and outcomes.

Over the years I have seen countless poor results from saline implants placed above the muscle in women of all ages, a situation which is exacerbated by those with thin skin. Even more disheartening are those women in their 20’s who have sustained permanent damage by what I consider to be very poor “choices” by their surgeons.

The following video illustrates one such individual who is in her mid 20’s. Note the severe static and dynamic rippling, skin stretching and very poor cosmetic appearance.

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Video of Saline Implants Above Muscle

If you would like additional information on breast implants, breast augmentation or any other plastic surgery procedure that I perform or to schedule a consultation, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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