How Do Saline Breast Implants Look if Placed over the Muscle?
Doctor Answers (26)
Saline Implants over the muscle
So, see as many surgeons (Board Certified Plastic Surgeons) as you feel comfortable with, review their results, above and below the muscle, and evaluate what results most exemplify your goals and go with that surgeon!
I hope this abbreviated response helps!
Breast Implants placed above the Muscle
You need to go to a Plastic surgeon with experience. I have had very nice success in a select group of patients. First and foremost, you need good tissue coverage to avoid rippling. The new silicone implants are more ideal for the subglandular pocket.
Saline Implants on Top of the Muscle are NOT for Most Patients
- ...already has a fair amount of breast tissue.
- Saline implants tend to ripple more than silicone.
- Hence, those implants need some sort of coverage to camouflage that rippling.
- That coverage can come from the muscle or from breast tissue.
- If a woman's breasts are already big, but she would like them even bigger, placing implants on top of the muscle is usually OK.
- ...wants the most natural results when she exercises (nearly) naked(!)
- The breasts are naturally on top of the muscles.
- Therefore, if the muscles move, the overlying breasts shouldn't move that much.
- However, if the implants are beneath the muscles, the breasts might move unnaturally when the muscles contract.
- Since most women don't exercise naked, this is a minor issue for most patients.
- Nevertheless, some women do compete in sports in small bikinis, and they are aware of breast distortions with shoulder/chest muscle contractions (such as beach volleyball players, surfers, body builders...see below)
- ...is a body builder.
- Body builders have very well developed muscles.
- Contraction of those big muscles would significantly distort the positions of sub-muscular implants.
- These women do pose nearly naked (in small bikinis) while flexing their muscles.
- Even though these women do not have a lot of body fat, implants on top of the muscle are generally better.
- In competitions, the rippling of the implants looks less bad than implant distortion.
- ...has droopy breasts and prefers to avoid formal lift-up procedures
- Implants themselves provide breast rejuvenation.
- The muscles tend to mute the rejuvenative/lift-up effects of breast augmentations.
- Even though many women need mastopexies (lift-up surgeries) at the same time as their augmentations, some patients prefer to avoid the additional scars of mastopexies and accept the limitations of implants on top of the muscles.
- ...is looking for a quicker recovery
- Most breast implants surgeries do not require a long recovery.
- However, positioning of the implants below the muscle is more uncomfortable.
- Staying on top of the muscle is much less painful.
- to minimize rippling
- to reduce excess scar tissue around the implants (known as capsular contracture)
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Saline Implants above the muscle
It takes at least 2.5 to 3.0cm of soft tissue coverage to be able to use a saline implant in the sub glandular position and then over time as hormonal, metabolic and signs of aging occur, the soft tissue coverage can thin out and the breast may look like a water bag, not pretty. Gel implants work better over the muscle as opposed to saline.
Saline breast implants placed over the muscle
As you can see from the varied responses, most of us agree that saline implants placed over the muscle can potentially give you a full but somewhat unnatural look. If you have a lot of your own breast tissue to camoflauge the edges of the implant, it will look more natural. Some patients do want it to be obvious that they had implants placed, but for those that want a natural look and prefer saline implants, I would recommend placement under the muscle. Good luck, /nsn.
Saline or any breast implants "above the muscle"
Saline implants placed above the pectoralis major muscle will look ripply, noticeable, obvious, and unnatural. With thick enough skin or enough breast tissue this may not be the result at first, but the experience has been that skin doesn't stay thick and breast tissue doesn't always stick around over time. Usually short term but nearly always long term, saline breast implants will look obvious.
Gel-filled breast implants can initially look natural above the muscle if they are sized and placed properly but will still very likely become noticeable as time goes by and the skin and tissues age. For a natural look, you don't want to see the border or bulge of an implant in the upper and medial parts of the breast. It's normal to have a bulge and an edge to the lower and lateral parts of the breast where the muscle doesn't cover anyway.
Experience has shown rather conclusively that all breast implants should be placed behind the pectoralis major muscle to provide padding, protection, and partial separation of the implant from the breast tissue. This provides a better result both short term and long term.
The other advantages to sub-pectoral (below the muscle) placement of breast implants are possible reduction in capsule contracture rate and ease of obtaining mammograms with implants in place. The disadvantage or trade-off of below the muscle positioning is muscle pull across the lower part of the breast on actively flexing the pectoralis muscle. This can be minimized by release of the lower-lateral border of the muscle during the placement of the implant (dual-plane release).
Saline implants above the muscle
Subglandular breast augmentation: breast implants over the muscle
Breast implants placed over the muscle will have less distortion by the muscle, though the upper part of the implant will likely be noticeable. It can give a somewhat "unnatural" look and feel, though this depends on how much native breast tissue you have. Advantages include easier recovery, less implant movement with muscle contraction and maintenance of muscle strength. It is a valid option in the right patient.
It depends on your soft tissues
Saline implants placed over the muscle can look very natural. It is dependent on whether or not you have enough soft tissue (skin, fat and breast) to adequately cover and camouflage the implant. Consultation with a board certified plastic surgeon will determine if you are a candidate. Good luck!
Saline implants above muscle may not look natural
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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