what detemines overs or unders?

[kittie]

Doctor, what determines overs vs unders aside from breast tissue and amount of cc's? Does age become a factor as well, in regard to mammograms? Also silicone and saline, is that, for you, based on the patient's preference or do you, prefer one over the over. thank you for your time.

[Dr.Hueneke]

Kittie,
I always let patients make the decision. I strongly recommend submuscular. The position of the implants is more stable, better coverage, mammograms are more accurate, data suggest lower capsular contracture rate, etc. The reasons to go this route in my opinion extremely convincing. I have performed 99.5% submuscular. Saline or silicone choice is up to the patient. The younger the patient the less likely I recommed silicone. Alot has to do with how much the implant will be felt. The more tissue you start with or put another way the less implant you use, the less important the makeup of the implant. Since women will have to consider what needs to be done in case of rupture, I go over what that looks like for both types of implants. The patient in the end must weigh in the balance the pluses and minuses of each one. A majority of my patients are still choosing at this point. Hope this helps.
Dr. Hueneke
Nashville, TN

[kittie]

yes it was helpful, thanks for your time. its always a hard choice, but i want to work with my Doc as a team, not my way or the highway or his/her way and the highway. I will see what my 2 consults have to say in regard to saline, silicone, pros, cons, etc. again, thanks

[Dr.Hueneke]

Kittie,
Based on your stats, I would probably recommend sub-muscular. Silicone may have some advantage for you. You will have to weigh the pros/cons with the doctors you visit. Other differences include price and incision size/location. The silicone implants run $1000 more in my area of the country. The incision I use is around the nipple because it heals so well. Silicone implants need a larger incision and I place them from under the breast. The incision size is twice that of saline.
Dr. H

[kittie]

silicone is something I am not sure of based on mammograms but if it is behind the muscle, maybe i can still get the mammograms. I am not closed minded to silicone, will see what my consults say and go from there. I have goals and with my surgeon, we can manage to meet them i think. thanks for your suggestions and recommendations and taking the time. I will discuss the plus and minuses of both. I do have a choice of incision apparently with both if I choose saline, but silicone i do not.

thanks again, have a great day