Patients with thick glandular tissue or fatty breasts often have the breast implants placed in a sub-glandular position (overs). This option is associated with a very quick recovery for most of Mr Turton’s patients. It can help to maximise the shape in the cleavage area too. Mr Turton prefers to avoid macro-textured implants now, and Mr Turton will look at micro texturing, nano texturing and Siltex texture for this option. For other patients, the gland of the breast may be too thin to fully hide a silicone breast implant so that under are a better option. Very slim patients or patients whose breast tissue has atrophied (thinned) after weight loss or child birth are classic examples where this might be the case. Philip Turton performs very detailed assessments of his patients in his cosmetic breast surgery clinics. He will specifically use a tissue calliper to accurately measure the breast tissue thickness at different sites around the edge of the breast. If the tissue is borderline or too thin, Mr Turton recommends partial sub-pectoral placement of the silicone breast implants for most of his breast enlargement patients unless another reason exists for a different approach and there are other options! Mr Turton will use a ‘dual-plane’ technique to optimise the muscle coverage over the upper edge of the silicone implant and carefully operate to allow good implant shape development in the lower breast where the muscle does not reach and ensure patients recover more quickly. Careful implant selection can help minimise visible rippling too and this combined with his expert techniques is especially important in very slim women. However, even if soft tissue coverage is very good, Mr Turton may advise that it is still preferable to place the implant behind the muscle; one good example is so that he can carry out breast enlargement using a smooth silicone implant instead of a textured silicone implant. Smooth implants should usually always go behind the muscle to keep capsular contraction rates low. Combining this with his 14-point plan to reduce the risk of infection and capsular contraction gives his patients the best outcomes. However, going behind the muscle takes a little longer when operating and with the recovery. Mr Turton advises patients to plan a little longer before returning to upper body exercises and swimming. However, in the hands of an expert oncoplastic and aesthetic breast surgeon like Mr Turton who does this type of surgery all of the time, and has a track record of excellence, you will find you are given the best advise, and whichever approach is used you by him, you will have an optimal recovery plan. Most patients return to work after just one week.
In the future, it is preferable not to train the pectoral muscles after implants have been placed behind them as it makes the implants move about, and can cause a visible distortion to the breast during the muscle contraction (animation). Implants behind the muscle also make life a little easier for the radiographers doing screening mammograms. You are strongly advised to see a specialist like Mr Turton who knows all of the the ins and outs of breast enlargement surgery and can advise on the best options for you. Have a look through Mr Turton’s breast augmentation information sheet for general advise: https://cosmeticbreastsurgeon.co.uk/augmentation-support/