I'm 18, 5'1", 112 lbs. I'm naturally a B cup and I'm considering saline breast implants to become a D cup. Should I go for under or over the muscle and would it cause the chances of the implant to rupture more one way?
With Breast Implants, What Placement Is Best For Me? What Could Cause Rupture?
Doctor Answers (12)
Breast Implants Best Placement-under muscle or over breast?
If possible placing breast implants under the muscle provides thicker coverage of the implant and a more natureal. This is particularly important for saline implants because they tend to form ripples with time and there is a better chance of hiding the ripples under the muscle. However if your breasts are sagging, under the muscle may cause a snoopy deformity.
Rupture rate for saline or deflation rate is the same under or over the muscle.
Cup size is hard to predict. Check the link below for information on how to choose breast implant size. The Rice test is the best
Breast Implant Positioning and Rupture?
Thank you for the question.
I think there are many advantages of placing breast implants and the “sub muscular” ( dual plane) position.
Although breast implants in the sub muscular ( or dual plane) position may experience “distortion” with muscle movement (workout) I still think it is in your best interests (and that of most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).
The submuscular positioning also tends to interfere with mammography less so than in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.
You will find that there is no difference In leakage/rupture rates with implants placed above or below the pectoralis muscle.
In regards to achieving your desired results after breast augmentation surgery, it will be very important to communicate your size goals with your surgeon. in my practice I find the use of goal pictures to be very helpful. I have found that the use of words such as “natural” or “D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. Placing breast implants on top of the skin ( pre-operative “sizing”) is not necessarily accurate either.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
I hope this helps.
Saline submuscular implants
The submuscular placement has many advantages such as a lower capsular contracture rate, and better coverage with less thinning and implant show over time. Implant rupture rates will not be affected by the pocket location.
Best of luck, peterejohnsonmd.com
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Breast implants will probably achieve your goals
If you are presently a B cup and want to be a D cup, then breast implants will most likely help you achieve your goals. I suggest either saline or silicone implants, placed underneath the muscle. With your height and weight, I would recommend implants in the order of 390 to 420 cc's would probably be about the right size to achieve your goals.
Saline breast implants should go under the muscle
As an 18 year old, your breast implant choice is limited to saline. Those are the rules based on the FDA approving breast implants. At 22 years of age, one can chose between saline and silicone. Saline implants don't look or feel very good on top of the muscle. They often show ripples and wrinkles. I strongly recommend submuscular implants for you.
Subglandular v. Submuscular Implants
There is no data that shows that the plane in which implants are placed makes a difference in rupture rate. It does make a difference in the way the implants look and feel In a thin woman, like yourself , an under the muscle inplant gives more coverage to the implant and thus appears more natural. You are still too young for mammograms, but when you are at the recommended age for breast screeniong, an under the muscle (dual plane placement) allows for better reading of the test.
No good reason to put implants on top of the muscle
Thank you for your question. There is no difference in rupture rates under the muscle vs on top of the muscle. There are a variety of problems with implants on top of the muscle including a less natural feel, less natural appearance unless you have a lot to cover up the implant, more rippling, a higher risk of capsular contracture and they get in the way more when getting a mammogram. You are very petite based on your height and weight. A D cup is probably rather large for your body type and I doubt that it would look very natural. Make sure that you see a board certified plastic surgeon.
Implant size and rupture
If you are very tin and do not have a lot of soft tissue coverage, I usually prefer to place the implants under the muscle. It provides more upper pole coverage.
Implant Rupture Rates not affected by pocket location
While there can be no doubt that there are many advantages to the average woman of placing her implants under her chest muscle, lowering the risk of rupture is not one of them.
Remember also that the decisions you make now will affect your life in many ways in the future- larger implants will cause your breasts to sag more than they would if they were more appropriate for your body, requiring more operations over your lifetime, with more expense, and more scarring.
I would advise you to think about your options very carefully and be sure that you are maximizing your safety, and your chances of being happy with the decisions you make both now and in the future.
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.