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Thread: Girls with OVER the muscle implants, quest.

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    God/dess Vyanka's Avatar
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    Girls with OVER the muscle implants, quest.

    I asked this same question on the implant forum but didn't get much replies. Figure i'll probably get more replies here.

    Anyway, i've been wondering for those of you who have over the muscle implants.

    How long have you had them and how often do you have to massage?

    Also, how do you get your breasts examined? I read somewhere that you have to get a MRI to exam your boobs. And that insurance wont cover for it, not fair. And the cost of an MRI examination is $1000.00 Is this true? Someone please inform me.

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    Senior Member Jessica Lords's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    I got my BA in 1998. I was told by my DR to massage as much as possible but to also try to sleep on your stomach because that is the best massage ever. My breast look very real...but I had bigger breast to start out with.

    I never heard of the MRI....but my dr suggest an examine every 6 months-he looks for more than just lumps but swollen lymph nodes under the underarms....abnormal looking nipples,color....if he is suspitious (sp?) he orders and ultrasound.

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    Senior Member Sassy~n~Sexy's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    BA 2 1/2 years ago...over the muscle...and I only massaged for maybe 2 weeks. Cogesive Gel doesn't require much massage. Mine are super super soft!

    I have a regular breast exam done by the doctor and a mamogram as well...no problems.
    "Just hold me close boy 'cause I'm your tiny dancer"

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    God/dess Gynger's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    Personally, I think over the muscle looks more natural.. I was and am still considering getting mine done simply because as I get older (mid 30's here) and a kid later, I'm starting to drop a bit... of course, I've also lost some weight... so thank you for posting this Vyanka, I was wondering this myself.


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  5. #5
    smartcookie
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    Default Re: Girls with OVER the muscle implants, quest.

    I wonder why it is that some women I know did fine with over the muscle, and others get horrible capsular contracture. Does anyone know the answer?

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    God/dess Emily's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    I don't think anyone knows why capsular contracture occurs.

    Also keep in mind that with overs, you're more likely to get an interference with a mammography and more likely to "bottom out".

    Then there's cosmetic issues like rippling and if you get getting overs to fix sag, you will probably need it repair later on. This is according to my PS....his exact words (from his website) are:

    "The result of implants over the muscle provides a round augmented look in many patients, but many women prefer the round and somewhat less natural look. In the "over" approach the implants are inside the breast. Advantages are ease of the surgery, which can be accomplished by almost any surgeon, avoidance of mastopexy in mild ptosis (although it usually makes the ptosis worse later), less post-op discomfort, since only skin and fat are cut. This approach allows insertion of oversize implants, which is again what some women want. Disadvantages are marked interference with mammograms (about 40% obstruction - see reference below), clear visibility and feel of implant edges, visible and palpable rippling of the skin over the implants, especially with any textured implants, higher rate of capsule contracture, high rate of later implant downward migration or "bottoming-out", and difficulty correcting later ptosis problems when they occur. For the above reasons I seldom recommend implants over the muscle anymore."

    I don't know much about massage. Some PS's say massage daily for life. Some say don't do it at all.

    I don't know about MRIs, but I haven't heard anything. I mean, it's not like you have to report getting a BA to your insurance, so how would they even know you got one?

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    God/dess Vyanka's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    SC, from what I read with overs they have to massage bc if not they will get CC. Under, the muscle is already massaging it automatically.

    I don't know how long is the average time to keep massaging though.

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    God/dess Vyanka's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    I def. want to do the switch from salines to silicones. But i've been thinking where. Also from what I read you can't see any ripples if you do overs with cohesives. Ah, I don't know. I just like the move with overs.

    Don't know if with cohesives they'll move the same like real boobies if under?

  9. #9
    smartcookie
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    Default Re: Girls with OVER the muscle implants, quest.

    There's another option called subfascial placement. The fascia is a paper thin layer of tissue over the muscles. When a BA is done this way apparently there is less of a chance of capsular contracture. I have no idea about bottoming out. An acquaintance who is a bodybuilder had cogels done this way by this doc:

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    God/dess Vyanka's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    That's interesting.

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    Default Re: Girls with OVER the muscle implants, quest.

    My friend got the most beautiful boob job I've ever seen. She got silicone round over the muscle. She went from an A cup to a large C with incision at the nipple. THey were the best I've ever seen. She said this Doctor only placed imlants over the muscle.

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    God/dess Vyanka's Avatar
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    Default Re: Girls with OVER the muscle implants, quest.

    Do you know who was her Dr.?

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    Default Re: Girls with OVER the muscle implants, quest.

    It was a surgeon in Czech Republic, can't remember her name though.

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    Default Re: Girls with OVER the muscle implants, quest.

    I am in the middle of researching for my BA, and I am interested in overs too. I have had three consultations: Dr.Gray (SF), Dr.Fisher(LA), and Dr. Eskanazi (SF). Dr. Eskanazi is my favorite, and she does overs almost exclusively. Here is what her website has to say about unders (subpectoral) vs. overs (subglandular):

    ABOVE OR BELOW THE MUSCLE
    This is a controversial topic, even among plastic surgeons. The answer to this question will vary according to the individual patient. This discussion is intended to tell you the advantages and disadvantages of each option so you will better informed about which option may be best for you.

    Historically, the first breast implants were placed above the muscle. However, these implants (which were silicone) often ended up developing capsular contracture. Then in the 1980’s, surgeons learned that by putting the silicone implants below the pectoral muscle, the incidence of capsular contracture was reduced. It is still not understood why this occurred. Because of this finding, however, many surgeons began routinely placing implants below the muscle. Then, in 1992, the FDA removed silicone implants from the market, and saline implants became the implant of choice for breast augmentation. Although many surgeons still routinely placed their implants below the muscle, it was not known whether this reduced the incidence of capsular contracture with saline implants. Since that time we have learned that saline implants perform differently than silicone implants. Studies to date show no discernible differences in capsular contracture rates in saline implants whether they are above or below the muscle.

    The primary difference between subglandular (above the muscle) and subpectoral (below the muscle) implants is not so much appearance but feel. In a still photograph, it is usually not possible to tell the difference between the two. The difference becomes apparent in the dynamic sense. For instance, when a woman with subpectoral implants flexes her pectoral muscles, the implants will move down and out. Some surgeons have called this the "dancing breast syndrome." This may be apparent at the gym, for instance. Also, as part of the muscle is detached from the bone, subpectoral implants can sometimes affect muscle strength and function. For women who are very athletic, subpectoral implants may be less desirable than subglandular implants, which do not affect muscle function.

    Advantages of Subpectoral Implants: Theoretically, mammography is a little more sensitive if implants are subpectoral. We recommend subpectoral implants in women who have had breast cancer in the opposite breast, and in women with a strong history of breast cancer.

    In very thin women, subpectoral positioning may reduce the appearance of implant rippling in the upper part of the breast. However, rippling may still occur, whether the implant is above or below the muscle. Furthermore, if the implant is going to be palpable, it is usually in the lower part of the breast, where the muscle does not cover the implant anyway.

    Disadvantages of Subpectoral Implants:
    Subpectoral implants will move whenever the muscle is used. This can occasionally be uncomfortable and can look unnatural. Also, sometimes these implants tend to ride too high, and do not look good in women with slightly droopy breasts (i.e. after childbearing.) Muscle function can be slightly affected as well. The operation is also more painful initially.

    Advantages of Subglandular Implants:
    Subglandular (above the muscle) positioning of the implant is more natural anatomically and therefore the implant will move more naturally with the body. Also, the surgery is less painful initially. Muscle function is unaffected.

    Disadvantages of Subglandular Implants: This position may decrease the sensitivity of mammography. Some surgeons think that subglandular positioning increases the rate of capsular contracture, although there is little data to support this with saline implants.

    Our recommendations: In general, our patients usually prefer the subglandular approach, as this tends to produce a natural look and feel. Satisfaction has been very high, and our rate of capsular contracture has been very low. Also, many of our patients are athletic and they appreciate the fact that the implant is unaffected by muscle movement and that function is unaffected.

    We recommend subpectoral positioning for women with a history of breast cancer on the other side, for women with a strong family history of breast cancer, and for women who have capsular contracture with subglandular implants. Again, the decision as to which position is best will really be best made after consultation with your surgeon.

    SUBGLANDULAR IMPLANTS

    Advantages

    * More natural anatomically
    * More natural when moving
    * Less invasive surgery
    * Less painful surgery Advantages
    * Mammography slightly better
    * Recommended in breast cancer patients

    Disadvantages

    * Mammography a little less sensitive


    SUBPECTORAL IMPLANTS

    Advantages

    * Mammography slightly better
    * Possibly less upper pole rippling in very thin women
    * Recommended in breast cancer patients
    * Possibly less upper pole rippling in very thin women

    Disadvantages

    * More painful surgery
    * Less natural with movement
    * May be uncomfortable in athletic women

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