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Can a Small Implant Placed Above the Muscle Look Natural in a Thin Woman? (photo)

asked 6 months ago by Alice87
Latest answer by J. Jason Wendel, MD
Question viewed 469 times
Tags: above muscle, natural appearance, over muscle, thin

I am having doubts between submuscular and subfascial placement. I am a thin woman, which for most PS is a sign to go with submuscular or dual plane augmentation. I want them to look good but I am afraid of distortion of the breast with muscle contraction, rippling and implant edges being very visible. Can a small implant 200cc - 250cc placed in the subfascial plane look natural in a thin woman? Or is it better to consider a 280cc placed submuscular? I am 5.1ft, 88lbs and BWD of 11cm. Thanks

13 answers to Can a Small Implant Placed Above the Muscle Look Natural in a Thin Woman? (photo)

Breast Implant Above or Below Muscle?

Dear Alice 87, Thank you for your question and photographs. It would be easier to give you good advise in person than with this limited information. You have concerns about some of the ways a below the muscle/dual plane positioning can look unnatural. I would put more emphasis on the ways an above the muscle implant can look unnatural. You have a petite frame and low body weight. A dual plane placement would give more tissuecover over the implant and hide... more

Mary Lee Peters, MD
Seattle Plastic Surgeon

A Small Implant Placed Above the Muscle Look Natural in a Thin Woman

Yes it can. I would put silicone implants over the muscle. Looks like you have mild asymmetry and might use two different sizes. Implants cant go under the fascia -- that is not a real operation, they either are over the muscle or partially (dual plane) under. Most of my implants now are through the nipple to minimize the scar and silicone over the muscle. You should do well.

William B. Rosenblatt, MD
New York Plastic Surgeon

Over or under the muscle for breast augmentation

Yes, a small implant 200cc - 250cc placed in the subfascial plane can look natural in a thin woman. A 280 cc implant is only 12% larger than a 250cc implant. If distortion on muscular contraction is a big issue for you, go subglandular/subfascial. Be advised, however, that submusclar can be easier for mammograms and has a lower rate of capsular contracture.

J. Jason Wendel, MD
Nashville Plastic Surgeon

www.mc.vanderbilt.edu

Breast Implant Placement

I favor putting implants under the chest muscle because my radiology colleagues think this position interferes less with mammography and the early detection of breast cancer than if the implant is placed on top of the muscle. Not all surgeons agree on this, but I like to err on ... more

Joe Gryskiewicz, MD
Minneapolis Plastic Surgeon

Go with submuscular augmentation

It is a mistake to have sub glandular augmentation due to the much higher incidence of capsular contracture, rippling and visible implant edges. A properly done biplane technique without excessive muscle release will get you a great result without excess muscle motion.

John Squires, MD
Denver Plastic Surgeon

Breast implant size, type, and position

The standard after many years of experience and improvements in pocket formation and muscle adjustment is to place breast implants below the pectoralis muscle for the central and upper part of the breast for short term and long term results of padding, protecting, and camouflaging the presence of the implant. This helps avoid the rippling and implant edges you are concerned with and with proper dual plane release of the pectoralis muscle you shouldn't have significant distortion with... more

Scott L. Replogle, MD
Denver Plastic Surgeon

Submuscular vs Subglandular Implants

The over the muscle, under the muscle question has no simple answer. Either position will result in a natural appearance if the procedure is performed well and an appropriate sized breast implant is selected. These two aspects of the procedure are most important. Different plastic surgeons feel strongly one way or the other, sometimes for no reason other than they do it more often one way or the other. One option may work better for a certain type of patient and this is related... more

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon

Breast implant position

I think you answered yoru questions yourself. FIrst please note your aysmmetry( everyone has it). But with thin patients it is often better to place them in a dual plane position.

Steven Wallach, MD
Manhattan Plastic Surgeon

Treatment of asymmetric breasts

Your posted photo shows widely spaced breasts without cleavage, stretched out areolae,right breast crease higher than the left, right nipple higher and further from the midline than the left nipple and right breast smaller than left. Every approach has its pros and cons you will need to weigh those before deciding what to do. Under the muscle implants can distort with muscle movement if the muscle release is inadequate but the risk of visible rippling is less. In your case it is as or... more

Aaron Stone, MD
Los Angeles Plastic Surgeon

Positioning of Breast Implants

Thank you for the question. I would suggest sub muscular ( dual plane) breast augmentation in your case. 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... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Implants below or above the muscle

First, we need to clarify the facts. Implants above the muscle have a higher chance of visibility and rippling than those below the muscle. Ultimately, the visibility will be related to the size of the implant vs the amount of breast tissue present. You appear to have sufficient amount of breast tissue to hide a smaller implant. You should also be aware that although there can be distortion of the implant when they are placed under the muscle you will probably... more

John P. Stratis, MD
Harrisburg Plastic Surgeon

Implants over the muscle is good for some

Muscle distortion can be a problem, and also a smaller implant can pose a challenge under the muscle if it will not fill out the breast envelope well. Subglandular augmentation can work out very well and it appears you have enough coverage for an excellent result. You do have some asymmetry which will be only partly be corrected with the implant. Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Rippling And Visible Implant More Likely ABove Muscle

I am a bit confused by your question. However, if your are concerned about rippling and visible implant edges, both of these problems will more likely occur if you have your implants placed above the muscle. I have not seen submuscular implants lead to distortion after the first few weeks have elapsed.