260cc Under or over the Muscle?

Hi, I'm 38 years old, 132 lb and 5'8'. I have breast fed two children and am a B cup. I'd like to increase my size to a C cup and have been recommended 260 or 300cc silicone implants under the muscle, due to not having enough fat tissue to cover the implant. I had a consultation with another surgeon today who recommended 260cc silicone implants over the muscle. He said muscle is very thin and does not provide much extra coverage, and I could end up with double bubble. Which is the right choice?

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age 35-44 5 ft 8 in to 6 ft 0 in silicone implant 130-149 lbs placement second opinion

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7 Doctor Answers | Asked by Ginnie2012

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You may need a lift

You have told us that you are size B and desire size C. However, you have not told us your bra size. If you are 32 or 34 then each 100 cc of implant will correspond to 1 cup size change. If you are 36 or 38 then each 200 cc of implant will correspond to 1 cup size change. From this, you can determine what size implants are required to get you to size C. Silicone gel implants are better than saline implants since they feel and look more natural. The... more

Thin patients are best advised to have the implants placed under the muscle

Most plastic surgeons place the implants under the muscle. Usually this gives a more natural appearance. This is particularly important for someone thin like you. The "double bubble" with submuscular placement (same as dual plane) is a myth and you should definitely not worry about that. I would recommend that you go with the larger size, at least 300 cc. You don't want to think later, why did I not go with a larger size? The average volume in my... more

Breast implant size selection

It is difficult to make any recommendations without a formal physical exam. I generally prefer a dual plane technique for my breast augmentation procedures. As per size selection, I consider two factors when selecting implants for my patients: 1.Dimensional planning 2.Gel Implant Sizing system Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form... more

Double bubble deformity and implant size

I think using a small implant in the submuscular position will not result in a double bubble deformity - as long as the implant is not substantially wider than your breast foot print, the infra-mammary fold is preserved, or reconstructed if it is violated, then the DB deformity is not a concern.

Under or over the muscle for BA

260cc is a modest sized implant, especially with your height and weight. I realize that you only want to go up one cup size, and I think that this size implant will do that, but you need to make sure that you are not expecting too much from the implant. Without a photo it's difficult to say. To answer your question it is perfectly fine to go under the muscle. Even if your muscle is "thin" it will still provide you with additional coverage. In fact, if you are that thin that your doc can... more

Breast implants under the muscle

Without a photo this doesn't count as advice but unless you had some very unique anatomy, I would go under the muscle for the maximum implant coverage. Done properly, your risk of a double bubble should be exceedingly small especially if the inframammary crease is not disrupted.

In front of or after the muscle, some insights.

Whenever possible in front of the muscle will lead to less discomfort in the postoperative period. If the skin is thin and there is a need to ressect partially the skin envelop to improve the breast design, a retro muscular fashion is often advised.