I Am 28 5'8 165lbs 36A Wanting Saline Implants Uncertain Over/under Muscle? Doctor Answers, Tips
Breast Augmentation: Q&A
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I Am 28 5'8 165lbs 36A Wanting Saline Implants Uncertain Over/under Muscle?

29 Doctor Answers | Asked by sweet33 in Ohio
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Usually, Saline Implants Are Placed Under Muscle

First, consider what your body type is and how much of your natural breast tissue you have. If you are thin and have little of your own natural breast tissue, then chances are sub muscular placement is better. This is because the implants (regardless of whether they're saline or silicone) won't be as palpable. Their outline won't be as visible, as well, giving you a more natural result in both feel and look. Saline implants tend to create more visible rippling than silicone.... more
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Under the muscle is BEST

At size 36 A each 200 cc of implant will correspond to 1 cup size change. Once you know you desired size then you can calculate the size implants you will need. Since you are very small (size A), implants will be palpable through your skin. I would recommend underneath the muscle for this reason. Also, silicone gel implants feel and look more natural than saline and will not ripple as frequently as saline implants. I suggest you consider silicone gel implants... more
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Implant Under or Over Muscle?

Whether using silicone or saline implants, most women choose going under the muscle because it gives you a more natural look. It also makes reading your mammograms easier, so that alone is a great benefit. With saline implants, going under the muscle may be better choice because the muscle and breast tissue will help to camouflage the implant better and help give you a softer more natural look. There is a good chance you may feel the implant more and possibly see and feel... more

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Saline implants over or under the muscle

With saline implants I always go under the muscle. I like to have as much coverage as possible so that it looks as natural as possible with the least possibility of rippling.
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Implants above or below the muscle

Thank you for your question. This is a very common question that many women have. As with so many things in life, there are trade off's with placing an implant in both positions. In order to safely place an implant above the muscle, there must be adequate breast tissue to help cover the implant. If not, a person will be able to see the implant easier, they will be able to feel the implant easier and as you get older and need mammograms, the... more
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Saline Implants

Whether you are a candidate for a saline implant should be determined by your surgeon. There is nothing wrong with a saline implant if you have the correct body habitus. I use both saline as well as silicone implants but most females choose silicone because they feel it is more natural and similar to a breast. If you have enough breast tissue coverage then saline works fine below the muscle (never above). I would recommend you seek out a surgeon who gives you both options and decide for... more
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Breast implants over or under the muscle

Thank you for your question. Regardless of the type of implants used, many plastic surgeons, myself included, favor placement of the implants under the muscle. This creates more coverage above the implant, which can limit rippling and make a more gradual transition on to the implant. This is especially true when using saline implants, which have more concerns about rippling to begin with. In order to place a breast implant above the muscle, there has to be sufficient tissue thickness of... more
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Under the muscle

Submuscular implants perform much better long term. Lower incidence of capsular contracture, malposition, wrinkling and palpability. Saline or Silicone are reasonable choices. Discuss these choices further with your surgeon.
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Location for saline implants

Saline implants, as well as silicone implants, are fine choices for breast augmentation. With your decision for saline implants, certainly they will provide a fuller and more rounded appearance, particularly of the upper pole of your breasts. Recent studies have shown minimal to no change in complication rate for submuscular vs. subglandular placement of implants in terms rupture, infection, capsular contracture, and radiologic imaging of your breast. So, your final aesthetic... more
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Saline implants and location placement

Hello, Thank you for the question. I think under or over the muscle can and is argued over among plastic surgeons really indicating that in the right patient and in the right hands either can provide a safe and beautiful result. Saline implants, on the other hands, are better placed under the muscle. The reason for this is the inherent characteristics of the saline implant. It tends to be firmer with a fuller and rounder upper pole. This in combination with... more
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Implant placement

You may consider silicone depending on what cup size you are wanting, but no question that submuscular placement is best. Capsular contracture is more likely with subglandular placement as is nipple numbness.
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Pocket Location for saline implants

If you have decided on saline implants, then I would definitely recommend submuscular placement of the implants for your breast augmentation. It would be much more likely that you would develop visible rippling if you have saline implants placed above the muscle (sub-glandular placement). In addition, the implants would be more palpable if they are above the muscle. Given that you are an A cup, it is even more likely that you would be at risk of rippling and/or palpability.... more
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Saline implant placement

Since saline is prone to more rippling, I generally recommend an under the muscle or dual plane placement of saline implants. The key to achieving the most natural result is camouflaging your implant. Please talk to your surgeon about his/her recommendations.
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Implant placement

Saline implants are more prone to rippling if placed on top of the muscle in patients with little to no breast tissue. Discuss a submuscular breast augmentation with your Plastic Surgeon.
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I usually position saline implants in submuscular position

Saline implants have a tendency to exhibit palpable and sometimes even visible rippling, especially in women with little of their own breast tissue volume. submuscular positioning provides a little more cover to camouflage the saline implants.
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Breasts Implants: Saline vs Silicone -- Over vs under muscle

Hello, young, tall, lady, with small breast cup, in my hands, you will be an excellent candidate for high cohesive or Monoblock Silicone Under the Muscle Implants. Good Luck
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Implants over vs under the muscle.

Thanks for your question. It's more common to place breast implants under the muscle on most women. You can still have a nice result if you place the implants on top of the muscle but the implants have a higher chance of sagging and getting hard. If your breasts are already droopy then going on top of the muscle might be the best option if you want to avoid having a breast lift. Hope that helps to answer your question.
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Saline Implants in A Cup Breasts and Submuscular Placement

Most patients with very little breast tissue are better served with submuscular placement to camouflage the implant. The saline implants do tend to have more rippling than silicone, and again submuscular placement is a better choice for saline implants in this case. Kenneth Hughes, MD Los Angeles, CA
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SALINE IMPLANTS

Hi Sweet33, Saline implants are more prone to become visible with rippling. An A cup woman does not have enough of her own tissue to adequately cover the implant to prevent visible rippling. If the rippling were to occur in the cleavage area you would not be happy. Submuscular placement in the right choice for you.
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Breast implants and pocket position

I usually place implants in a submuscular pocket to help minimize rippling. it is best to be seen in person to be properly evaluated.
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Implants

Since you are choosing to have saline implants I would advise you to have submuscular placement of the implants
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Submuscular vs. Subglandular Placement of Breast Implants

Most surgeons have an inherent preference for the pocket the implant is placed in. Both the subglandular and submuscular pockets are satisfactory in individual patients but in some cases one approach will be better than the other. I typically prefer the submuscular approach for breasts with little to no sagging. In cases of breast sagging of a modest nature a subglandular approach can be considered to avoid breast lifting, with its associated incisions/scars. In short, both approaches can be... more
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Sub muscular or Sub glandular Position for Breast Augmentation?

Thank you for the question. There are pros and cons to the placement of breast implants and the “sub muscular” position versus the "sub glandular position”. I will try to outline some of the differences here; you may find the attached link helpful as well. I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This positioning allows for more complete... more
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Best implant position when using saline

Will vary according to your own needs and anatomy. The preceding answers do illustrate some of the issues we have with saline implants but if you have adequate breast tissue, rippling will be a minimal issue. Your surgeon should help you decide on what is best for you after considering your concerns. As for which incision is best, that is also your choice but a recent study implicated axillary incisions as being associated with the highest rate of contracture. And... more
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Under the muscle

Hi I agree with the others here: Under the muscle is the way to go. Unders: hurt more take longer to heal ( drop ) but in the long run, look more natural, have fewer problems with rippling and capsular contracture. The majority of plastic surgeons still do under the muscle. In south america and most of europe ( and now parts of south florida and california), these are over the muscle but I believe that is a cost issue: over the muscles are less... more
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Best Option for Saline Implants

Thank you for your question. In most situations, saline implants are always placed under the muscle. In fact, this is also true for gel implants by most US surgeons. There is less chance for scar contracture around the implant and the results are more natural. Saline implants do not perform well in front of the muscle due to wrinkling or ripples. My preferred approach is a saline implant placed under the muscle via an axillary ( arm pit ) incision. I also think the implants should be filled... more
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Above or Below, always a question

Without any droop(ptosis) to the breasts, saline implants are best put behind the muscle. The lack of stability of a saline filler makes the implant more visible and palpable. Without photos, it is best to visit a board certified plastic surgeon who can go over the reasons for implant placement.
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Saline implants are best positioned under the muscle if possible to camouflage potential contour abnormalities.

Whereas silicone gel implants have few problems with contour irregularities above or below the muscle, saline implants have decidedly fewer of these aesthetic problems when placed below the muscle. I preferentially put saline implants under the muscle all other things being equal.
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Wanting Saline Implants Uncertain Over/under Muscle

Without photos and measurements, it is hard to give specific advice. Even with all that, the advice based upon an in person evaluation will carry much more validity. I would suggest finding a surgeon with whom you are comfortable, and review all options-- silicone vs. saline above or below the muscle size incision As a rule, saline implants are likely to have palpable and sometimes visible ripples when they are placed above the muscle in patients... more
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Comments (2)

NoMoreBoobEnvy (RealFriend) 11 Feb 2013
What did you decide?
SarahP (Community Manager) 8 Feb 2013

Hi There,

I just wanted to let you know that for questions like these, it is always helpful to attach a photo.

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