500cc Silicone, Under or over Muscle?

Hello Curiouslatina,

I'm not sure if you meant to re-post your question or if you just didn't like that answers you were given the first time!  As most of the surgeons who responded to your original post had said, including me, under the muscle is almost always the best place to put the implant. You will get a lot of projection and the muscle will provide a cushion to help make the implant both look and feel good.  Sub-muscularly placed implants also have a lower risk of capsular contracture, the most common complication after breast augmentation.

Your areola are relatively small, so I don't recommend an areolar incision.  You are an ideal candidate for an armpit incision.  This will give you a virtually invisible scar in the armpit that looks like a natural crease, and recovery is identical to an areolar incision.

Although there is not a lot of difference between 450 cc and 500 cc, I think that 450 cc would be best suited for your frame, tissue thickness, and probably your goal in terms of your appearance.

Best of luck.

There are benefits to both going over or under the muscle.  It really all depends on what you are starting out with. Under the muscle hides the implant better but then you have to deal with all of the muscle activity.  In your particular case I would recommend that you go below the muscle since your frame is rather lean to begin with. 

I would generally recommend placement of the implants under the muscle.  I believe this is especially true in thin patients (like you).   Sub-muscular placement increases the amount of soft-tissue between your implants and the skin and may decrease the rate of capsular contracture.

To better communicate with your surgeon your desires in terms of size, I would recommend that you show him/her the above photographs.  Based on your apparent goals and base diameter, I would likely place the 500 cc implant.  The Allergan high profile 500 cc implant has a base diameter of 13 cm.  You should realize, however, that the difference between 450 cc and 500 cc is less than 2 ounces.  Meet again with the surgeons and show them photographs of breast sizes that you feel are desirable.  Good luck.