Unders/Overs

[Whitney]

I was totally set on getting unders but lately I have been considering overs. Did anyone get unders and wish they got overs???
I mainly want overs because I want SLIGHTLY the more-fake look..... But, having 2 kids, I don't know if my breast tissue would support having overs. PLUS, I think my Dr. majorly prefers unders...................Grr. Decisions, decisions.

[redheadgirl]

Hi Whitney!
My PS doesn't do overs at all! I'm not sure why, maybe I'll ask for you while I'm there.............

[runnergirl08]

Originally Posted by Whitney

I was totally set on getting unders but lately I have been considering overs. Did anyone get unders and wish they got overs???
I mainly want overs because I want SLIGHTLY the more-fake look..... But, having 2 kids, I don't know if my breast tissue would support having overs. PLUS, I think my Dr. majorly prefers unders...................Grr. Decisions, decisions.

My ps only does unders. You can visit his website (Dr.DeWire).

http://www.advanced-art.com/Breast-Aug-Over-Under.htm

[FabBri]

Hey Whitney,

Same as the other girls, my PS prefers unders and 90% of the work he does is unders, but if someone has a strong preference for overs he will do them.

B

[tiffany]

Every PS has preferences. Mine does overs on 99% of his patients.

[HockeyBabe17]

I wanted overs at the time, but I wanted salines so there would have been a high chance of visible rippling... I ended up with partial unders & Im very happy with them, so no, now that I have them I don't wish I did anything different. The only thing that bugs me is a bit of distortion when I'm working out (which is every day) so I have to be sure to wear full coverage tanks/t-shirts to the gym.

[Mickey]

I have unders and love the way they look. I don't think that I considered overs.

[runnergirl08]

Originally Posted by ********

no i never wanted overs,i am not comfortable with the idea of overs interfering with a mammogram. unders as well as overs both have their pros and cons.but id rather have unders with regards to less mammogram interference with them.everyone is different so its a personal one.

I totally agree with you! I definatley feel more comfortable getting unders and being able to have an accurate mammogram *when the time comes*

Health is most important

[TXSGRL]

I've heard that it is not more difficult to detect breast cancer on someone with overs, It just requires a doctor that knows how to test women with implants. The mammogram is not harder to read for the technician, as long as they take additional views and know what they are doing. This is 2007, and technicians do this sort of thing everyday, due to a large number of women have implants nowadays. This is just what my doc told me...

[MANDY2BOYZ]

I worry about long term...like do they sag faster? I've seen both and you can get great results with both. I think its just a personal decision. Good luck

[Giggles]

True, more and more techs have experience with implants-BUT it takes a lot more manipulating to get the image they need. It's all based on the experience of the tech that's doing the films. Go somewhere where they have a ton of experience with implants and you should be good to go! If they don't have experience though-they may not compress hard enough or get enough of the breast tissue in the film.
Here was my deal with implants and mammos- they can see every scar- and those scars look like shadows on the films-thus causing the need for more views-more exposure to radiation.

[Xiola]

I think different placements for different breasts. I preferred unders but my surgeon said I'd look better with overs because of the shape of my breasts. I have overs and I have to say, the recovery is really not that bad. Few more risks with overs but each has their own pros and cons. I'd trust what the surgeon recommends for you. Usually girls with less breast tissue end up with unders.

[TXSGRL]

I just turned 27 end on Aug., and I've had 3 sonograms on my left breast due to what looks like an inverted nipple and underneath a type of fibrosystic mass. The day of my surgery I will be getting a mammogram just to be for sure.(they usually don't give mammograms to younger women, just mostly women who are 40 or over.) 2 years after my son was born, my nipple started to go inward a bit, but is not what they call "inverted". It is a "shy nipple". Breast cancer can strike at any age, as I have been stressing about this since i was 24, ever since my nipple started looking different. They have only done sonograms and say to "come back in 6 months" over and over. The placement of the implants I'm getting weren't my choice, it's just what the PS recommended for me. My mammo doc told me that whatever placement you get, there ARE qualified techs that know how to take additional views. I live in Dallas, TX, so i guess i don't worry about the mammo techs expertise since I don't live in B.F.E. The extra exposure to radiation does not scare me, I would rather them take additional views if they felt they needed to, with overs or unders. Also, it was said somewhere that overs have a higher risk of developing cc, which i believe to be untrue. Nikki developed cc TWICE and she had unders both times. If you are going to develope cc, then it's going to happen no matter what placement you have. But, like i said, i didn't choose overs for myself, my PS did. And I have been dealing with this breast cancer issue for YEARS, but all i can do is just trust what my PS says. So, please don't think that since i'm young that i have this " i'm not worried about breast cancer attitude", because it has definitely caused me lots of stress over the last few years. I've been waiting to hear i don't have cancer for almost 3 years just so i can finally go on a consult with a PS for implants. Again, Breast cancer is serious so every woman should stay on top of their breast when it comes to that, over and under girls. It's important that you do monthly self breast exams and see a doctor for an exam at least once a year.

[tiffany]

Originally Posted by tinabina

I love that it is my boob on top.

I'm confused by this. It's ALWAYS your boob on top. The only difference is whether it's under both your breast AND your muscle or just under your breast. Implants are never placed on top of your breast though.

[Sherry_T]

Originally Posted by HockeyBabe17

I wanted overs at the time, but I wanted salines so there would have been a high chance of visible rippling... I ended up with partial unders & Im very happy with them, so no, now that I have them I don't wish I did anything different. The only thing that bugs me is a bit of distortion when I'm working out (which is every day) so I have to be sure to wear full coverage tanks/t-shirts to the gym.

What distortion do you have?

[TXSGRL]

The pectoral muscle will distort with submuscular (unders) placement. if you try to get on a boat or out of a pool using upper body strenght, for instance, you will see the distortion when you pull yourself up when you have unders.

[Jess]

I have partial unders b/c I have very little breast tissue. Had my breast tissue not been an issue I would have loved overs. I hate the distortment I get when I flex. Karaoke went from unders to overs, you may want to PM her. I know she was very excited to be able to switch to overs when she had her redo and she loves them.

[Nanny66]

I resisted replying to this thread until now...and I feel for Whitney, she asked a straight question and only got maybe 2 straight replies to her question...
My reply is more to do with the other posts

I have overs , was told I would have partials, but during surgery, he changed his mind...

I do take breast cancer seriously ~ here in Uk mammograms aren't offered until 55 (I think) ~ but my placement of implants have never concerned me

As for x-rays, if they are that dangerous ~ I'm Stuffed....I've spent my last 40 years being x-rayed for a physical deformity that was detected at birth.

Overs are said to sag quicker than unders ~ true ~ but another 'problem' that doesn't concern me

I love the results of unders AND overs...overs doesn't mean fake, as in unders doesn't mean natural....

I've never been keen on these debates...something versus something...they hit on many raw nerves...

I have co gels, and never ever would I type that they are better than salines...they are all that we have here

Whitney ~ You're thread got side tracked, sorry x

I feel better now

[Whitney]

lol hehe thats ok... THANKS!!
I feel better when you say overs don't necessarily look more fake =)
That's kinda what I was hoping to hear
Regardless, I learned lots from this thread

[tiffany]

Whitney, here's a good article to help you decide:

Under or Over?
Choosing the Right Plane
By Richard A. Baxter, MD, FACS,
Plastic & Reconstructive Surgeon, Baxter Plastic Surgery Clinic
Like every other decision about breast implant surgery, the question of whether to place the implant under the muscle or over is the subject of much debate, with confusion and misinformation in every direction. Suffice it to say that there is no single best method that applies to every patient; the key is to establish priorities based upon individual anatomy, implant type, and several other factors.


First we need to define some terms. When the implant is placed in front of (above) the muscle, that is usually called subglandular, since the breast is a gland. Beneath the breast tissue is a layer of muscle, most of which is the pectoralis major. This muscle is shaped like an oriental fan, with the gathered part attaching to the upper arm bone and the outer edge attaching to the sternum, or breast bone, and the ribs. Since it is only attached to the chest wall around the edge, there is a potential space beneath it where an implant can be placed. When the implant is below (behind) the pectoral muscle, it may be called subpectoral or submuscular.

The term total submuscular is used when other muscles on the chest wall are raised in order to cover the sections of the implant that the pectoral muscle doesn't. Specifically these areas are on the outside (lateral) and the lower portion. Typically, the pectoral muscle covers about the upper two thirds of an implant. There are potential advantages to having total submuscular coverage but no agreement among plastic surgeons as to whether or not it is practical to do this in every case.

Why go under the muscle? There are several reasons why this is the most common approach for breast augmentation. (When implants are used for breast reconstruction, they are almost always placed total submuscular.) One important long-term consideration is that implants under the muscle seem to interfere less with mammograms. Implants may, however, still obscure some of the breast tissue. In theory, this could mean that an early breast cancer could be missed, or diagnosis delayed until the tumor is larger, though studies have shown no indication that this occurs in clinical practice. Special mammographic techniques called Eklund views are recommended for women with implants, and having implants does not mean that mammograms should be avoided.

Other benefits of submuscular placement are aesthetic; often times, the implants appear more natural. This is because the transition from the upper chest into the top of the breast is smoother, and the outline of the implant is less visible. This becomes much more important in thin women. The implants may be less apparent to touch when they are under the muscle as well. Historically, submuscular implants have been shown to be less prone to capsular contracture, which is a thickening and hardening of the natural scar layer that is formed around implants. There are other aspects that are probably more important in capsular contracture, however, so this isn't usually the deciding factor.

There are of course disadvantages to submuscular placement of breast implants as well, otherwise they would all be placed in that plane. Activity of the muscle, whether with normal use or with athletic activity, can affect the implant in several ways. Some believe that muscle activity "massages" the implant and that capsular contracture is less likely for that reason; there is little hard evidence to support that theory, however. Muscle activity can also push the implant out of position either during healing or over time. This can be seen as loss of cleavage, with implants being too far apart, or implants too low, called "bottoming out". These problems can be minimized by certain surgical techniques.

Another related problem is distortion of the breast with flexion of the pectoral muscle. When this occurs it is usually minor and typically the breast has a good shape when the muscle is at rest. It is in fact normal to some degree. More severe cases can be bothersome however, and correctable completely only by placing the implants above the muscle.

Subglandular augmentation is considered when there is adequate tissue for implant coverage and in cases where there is some sagging of the breast. In this situation, the implant will be too high relative to the rest of the breast if it is under the muscle. My own opinion is that this is sometimes an inadequate solution to the problem of sagging, called ptosis (the "p" is silent in ptosis). It may even contribute to worsening of the problem in the long term, resulting in what is sometimes called a "rock in a sock" appearance. A better approach may be to do a breast lift at the same time rather than place the implants low.

Athletes, body builders, and others with low body fat have a particular problem with choosing the right plane for implants. When they are subglandular, the implants can look obvious and artificial because the thin fat layer under the skin provides little camouflage, and breast tissue is often minimal as well. On the other hand, submuscular placement can result in unacceptable breast distortion with activity. There may be no ideal compromise in many of these cases, but there is another option called subfascial (pronounced like fashion). The fascia is a fibrous layer on the outer surface of the muscle, behind the breast. Although it is fairly thin, less than a sheet of paper sometimes, it is a distinct anatomic layer that can provide at least some additional coverage with the implant above the muscle. The subfascial technique has been very helpful in certain patients.

The final decision should be made after consultation and discussion of all of the factors that need to be considered. These include lifestyle as well as anatomic features. Decide what is important and ask questions: Is the surgeon familiar with all 3 planes of implant placement? What are the pros and cons of each for your specific concerns? What are the long-term considerations? Good outcomes relate to good information and informed choices.