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Ask Dr. Pelletiere (Illinois) In this forum, you can ask Chicago, Illinois plastic surgeon, Dr. Christopher Pelletiere, questions about breast augmentation and other plastic surgery procedures.


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Old 03-31-2015, 03:38 AM   #1
 
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What size and placement? Under the muscle placement or over?(photos)


I am a 19 year old girl and I want to get a breast augmentation but I am not sure what I should do too get the best possible result. I am 122 lbs, 5'5" and have a B cup. No children.

So I wonder, based on my stats and the look of my breast now(photos), what should I do? What will give me the most flattering result? I want big, noticeable breasts but not huge, I still want to be able to "hide" or at least tone them down if I want to. I have talked to a surgeon who agreed to give me 500cc silicone(UHP I think) implants over the muscle. But I am thinking maybe 500cc will be to small and I won't get the desirable result. Should I consider 550cc? What would be the best placement for my implants(I'm going to get silicone no matter size)?









I would really love to get a second opinion!

Thank you for your help!
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Old 04-01-2015, 02:36 PM   #2
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With your current breast size and shape, I think you would get a good result with a number of different options. It is hard for me to say what would work best for you without examining you, measuring your chest/ breasts, and feeling the tissues. If you want to be able to dress them down, than a ultra high profile (UHP) is probably not the way to go. The UHP are very round ( think ball look). Sometimes they have to be used based on a narrow breast width, but across the country, they account for less than 5% of the implants used due to the really round design. The HP implant gives nice volume and projection, but can still have a softer appearance ( not quite as round appearing). The volume really depends on what your tissues can handle and how much width you are able to accommodate. I would recommend going for a second consultation and seeing what another board certified plastic surgeon recommends. I hope this helps.
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The above messages are not intended to substitute for direct medical advice or patient care. Proper medical/patient care can only come with direct patient interaction and a full examination. If you cannot accept this policy, please ignore my messages. Dr. Pelletiere specializes in aesthetic and reconstructive surgery in and around Chicago.

Christopher V. Pelletiere, MD
1602 Colonial Parkway
Inverness, Illinois 60067
847.358.9444
office@pelletieresurgery.com

www.pelletieresurgery.com
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Old 04-01-2015, 02:39 PM   #3
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. . . And no reason to go above the muscle. That has a higher capsular contracture rate and chance of rippling over time. 95% of my patients are in the dual-plane ( partial submuscular ) position. It gives you the best of both worlds. Around the country, above the muscle placement is in the minority, and definitely not recommended if using an UHP device.
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The above messages are not intended to substitute for direct medical advice or patient care. Proper medical/patient care can only come with direct patient interaction and a full examination. If you cannot accept this policy, please ignore my messages. Dr. Pelletiere specializes in aesthetic and reconstructive surgery in and around Chicago.

Christopher V. Pelletiere, MD
1602 Colonial Parkway
Inverness, Illinois 60067
847.358.9444
office@pelletieresurgery.com

www.pelletieresurgery.com
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Old 04-02-2015, 03:08 AM   #4
 
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Quote:
Originally Posted by Dr. Pelletiere View Post
. . . And no reason to go above the muscle. That has a higher capsular contracture rate and chance of rippling over time. 95% of my patients are in the dual-plane ( partial submuscular ) position. It gives you the best of both worlds. Around the country, above the muscle placement is in the minority, and definitely not recommended if using an UHP device.

Thank you for your answer!

The surgeon I talked to said that I could have 400cc under the muscle, but if I wanted 500cc I would have to put it over. I asked why and he said that there was a risk that my natural breast tissue would sag over the implant(like on the picture) over time if he put an implant under the muscle, even if it was just 400cc. Why do you think he says that he can put 400c under the muscle but not 500cc? I really wonder.. it is not that big difference in cc's. Than he said that I could go for 400cc under the muscle now, wait a year and then get 500cc under the muscle. This sounds a bit strange to me.. but I didn't dare to ask. Another things I found peculiar is the is said that I risk having an implant would "bottoming out"(kind of like on the second pic) if he put it under the muscle. Can this be true? I did some research after the consultation and found that the implant has a higher risk of bottoming out if it is placed over the muscle. I am a bit confused..




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Old 04-13-2015, 11:59 AM   #5
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If the surgery is done correctly in the dual plane position ( partial submuscular), then there should be no reason your breasts would look like either of those pictures. If your surgeon is doing complete submuscular, then there is a chance your breasts could look like the first picture. However, that is an old technique and not done very often these days. Almost all th women who say their implant are submuscular actually have them in the dual-plane position, they just do not know it. I would go for a second opinion if I were you since it appears your surgeon utilizes older techniques and may not be comfortable working with that size implant. I hope this helps.
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The above messages are not intended to substitute for direct medical advice or patient care. Proper medical/patient care can only come with direct patient interaction and a full examination. If you cannot accept this policy, please ignore my messages. Dr. Pelletiere specializes in aesthetic and reconstructive surgery in and around Chicago.

Christopher V. Pelletiere, MD
1602 Colonial Parkway
Inverness, Illinois 60067
847.358.9444
office@pelletieresurgery.com

www.pelletieresurgery.com
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