With my size, what would be better; over or under the muscle? (photo)

I'm 5'10', I'm a transgender female. I posted a question recently on sizes. I plan on going with rounded silicone, moderate profile. 650 cc that's the size I want and no smaller. With the breast tissue I have now what will be the best option. Over or Under the muscle? What would be the option

Doctor Answers (3)

BA

+1

Thank you for your question.

I believe the placement of an implant under the muscle will give you better results. A 300-375 cc´s might be a good size for you.


Mexico Plastic Surgeon
4.5 out of 5 stars 137 reviews

Breast implants underneath the muscle is the best option for transgender female

+1

Thank you for your question and photographs.  If at all possible breast implants placed under the muscle R your best option long-term.

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in breast augmentation surgery in transgender individuals, and who has

Reputation in your community.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

With my size, what would be better; over or under the muscle?

+1

Thank you for the question. 

I think it is in the best interests of most patients, including transgender women, seeking breast augmentation surgery to have implants placed in the “dual plane” or 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 breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  they can be seen with breast implants placed in these sub muscular position.  

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C 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.

The use of computer imaging may also be very helpful during the communication process.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.

I hope this, and the attached link (dedicated to "transgender patients"), helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

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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.