Are 500cc To Much For Over The Muscle?

I went to 2 diff dr for consults about breast augmentation and im confuse now,,both gave me diff opinion lets see if you can make get the best for me or help im 31 yrs ,height 5' 3" , weight 127 , CUP 34A , BWD 13.0 , MOTHER OF 2 girls and i want to be like D or full D THE first dr said the best for me are silicon with 450 cc over the muscle ,Areola Incision and the second dr said silicon 500cc under the muscle ,Areola Incision.what you think over or under muscle for me and why?

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500-549cc over muscle

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12 Doctor Answers | Asked by curioslatina in Los Angeles, CA

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Implant pocket location

Over or under really depends upon your anatomy. In most cases I prefer under because most of the women I see do not have a lot of soft tissue coverage. Hard to say without an exam.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Better results with implants behind the muscle

Without photos and even more importantly, an examination, size recommendations are pure conjecture. However, for many reasons including the relatively large size of the proposed implants, they should be placed in a submuscular pocket versus above the muscle. These large implants above the muscle will cause rapid stretching and thinning of the skin, will be felt more easily in an abnormal way, and may create creasing/ripples of your skin.

Breast implants are generally placed subpectoral (under the muscle)

There are many reasons to have your breast implants placed subpectoral (under the pectoral muscle). It's easier to interpret mammograms, lower incidence of capsular contracture (scar tissue) and a more natural contour to the upper portion of the breast. Those larger sized implants (450 and 500) are quite heavy and may lead your breasts to sag more quickly as you get into your mid-thirties; especially if they are in a subglandular (in front of the muscle) location. I would also... more

Are 500 cc implants to much for over the muscle?

With your height and weight, I feel that a 500 cc implant is too large. Although if placed correctly under the muscle, you could still get a nice result. If the implant is placed above the muscle, I feel that it will not only be too large but will cause future problems resulting in stretching of the skin and sagging.

Breast Augmentation

Hello Curiouslatina, Going under the muscle will give you the best chance of minimizing complications like capsular contracture and rippling in the upper part of the breast. There is not much of a difference in appearance between a 450 and 500 cc implant, but they are certainly near the appropriate limits of your anatomy, based on your reported BWD of 13 cm. In an ideal world, 400 cc might be a safer choice, I would need to examine you directly before making a... more

Over or under the muscle augmentation

I personally perfer under the muscle implants. They look and feel more natural in my opinion. I would suggest you look on line at photos of before and afters of women who start with your volume of breast, and pick out ones you like postop and have a size listed. you should also look for photos both above and under the muscle and pick out the ones you like. there is no wrong answer with under or over, it is personal preference.

Rick Rosen, MD

3 reviews

Norwalk Plastic Surgeon

How to pick breast implants.

1) This is the most common type of question on RealSelf. 2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical. 3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like. 4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake... more

Large Implants Above the Muscle

Large breast implants above the muscle is a recipe for a second procedure sooner than you would like. A 450 cc above the muscle and 500 cc below will "show" about the same, but if you are a postpartum A cup, then the implant will be MUCH more visible through the skin in an over-the-muscle position. There shouldn't be a question in a small breasted patient. However, without photos or an exam - all of this is speculation. Just don't try and choose larger implants to... more

Breast Implants Under the Muscle

Hello ~ The gold standard in the plastic surgery community is to perform breast augmentations under the muscle utilizing a "dual-plane" technique. There are surgeons, however, who perform breast augmentations above the muscle, and with good results. Both techniques are acceptable, and there are certainly indications to perform augmentations above the muscle. One such case would be a female body builder. However there are intrinsic risks with performing... more

Dual plane breast augmentation

Preoperative photographs would be very helpful. With a true base width of 13 cm, a 450 cc implant is not unreasonable. However, there are few indications to place the implant over the muscle. By placing large breast implants over the muscle, you can guarantee in time another procedure to address your stretched out breast skin, thinned breast tissue, enlarged Areolar diameters, and potentially widened scars. A better approach is a dual plane technique in which the implant is placed in two... more

Large Breast Implants Above the Muscle

Your question is a good one and raises a few issues. First, I think large implants should be placed below the muscle because they weigh more and the muscle provides additinal support against sagging. Second, 500cc is quite a large implant for a BWD of 13 unless you have a lot of loose skin and want a high profile implant. An implant size of 400-450cc may suit you better but it is difficult to say without an exam. Third, unless you have exceptionally large areolas, it will be a tight squeeze... more

Over or Under?

It's a bit hard to answer your questions without seeing a photo of where you're starting. That said, skin stretches easily- much easier than muscle. You can only fit so much under the muscle without causing damage, pain, or too much stretch. Over time is a different story because once the muscle is stretched you can certainly 'fit' more under it. This is a little of the concept of the way we do under-the-muscle breast reconstruction with implants... more