Is above muscle breast implant placement the best approach?

Hello, Much of that which you will find in plastic surgery is a matter of opinion. Over the muscle silicone gel implants have a higher rate of encapsulation (getting hard) over the long term. Then again they ripple less and you are thin. Even "under the muscle" implants in your case will probably be... more

Because you have some sagging, many surgeons may opt to place your implant above the muscle to allow more appropriate placement of the implant beneath your lower breast.  The downsides are a slightly increased  chance of capsular contracture and possibly a more visible implant edge or... more

It is hard to answer by just looking at one photo, but it is important to understand there are 2 options: above or below the muscle.  My preference is below the muscle, but what you probably need is an implant placed in a dual plane, which means the implant is partially under the muscle. The upper 2/3's... more

By the image you posted, you have some laxity of your skin and some mild asymmetry as well. My personal preference would be to place your implants partially under the muscle with what is referred to as a dual plane release (relasing a bit more of the muscle). This would lend you a better upper and middle... more

 I believe you should almost always go below the muscle (partial submuscular or dual plane are the terms).  These give better mammograms, look more natural, and probably have less capsular contractures.  Above the muscle implants can look like a ball in sock and matronly.  Not so pretty.

Most breast implants are inserted under the pectoral muscle (subpectoral).  The reason for this is a lower rate of capsular contracture (scar tissue), more natural appearance, and easier mammogram interpretation. This is not to imply that over or in front of the pectoral muscle is incorrect, however there... more

Hi! Your surgeon is absolutely right.  To correct mild sagging such as you have, the best thing to do is to put implants over the muscle.  This is what we do in New York, and t works great.