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Under Vs over the Muscle for More Natural Results?

I'm currently a big 'A', small 'B' cup, my height is 5'5.5", slim body frame and weigh about 119lbs. I'm 30 and have 2 children who were both breast fed. I would like to be a full 'C' cup, I've recently been to see a consultant who has suggested he will insert 260cc textured Silicone breast implants (High profile) over the muscle. Does this seem ok?

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A to C cup 5 ft 4 in to 5 ft 7 in under muscle 110-129 lbs

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16 Doctor Answers | Asked by dufu in uk

Doctor Answers (16)
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Why subpectoral (under the pec muscle) implants

Your instincts are correct. Breast implants today should be under the pectoralis muscle for a number of reasons but one of them is to pad, protect, and blend in the implant so it looks like a natural breast and not an implant under a breast. This is not just a choice thing that's up to the whim of the patient or the surgeon. It's based on decades of experience with breast implants. In my opinion, a surgeon who is still putting breast implants above the muscle, doesn't know how to... more

Breast augmentation under versus over the muscle

In general, most of us would agree that under the muscle is preferred in most cases, but you should know that for the right patient with the right anatomy, you can get a nice result with the implant placed above the muscle as well-- it really just depends on the surgeon's judgement, style and experience, and combining that with what your goals are. I would speak to at least one or two more plastic surgeons in your area and go with the one you feel the most comfortable with-- this will... more

Unless you are an extreme athlete put your implants under the muscle!

Dear Dufu, It is generally agreed that the best long-term results occur with under the muscle placement of breast implants. The implants are better protected, rates of capsular contracture are typically lower, and if you have saline implants or are very thin, rippling/waviness of the implant is less detectable. I typically only put implants over the muscle if patient use silicone implants and are extreme athletes (eg. body builders, martial artists, heavy weight lifters, etc.) The... more

Dead muscle?

I'm not sure I agree with what you've been told but there are many different opinions in the operation that you're seeking. I don't think you'll be a full C cup in 260cc implants, even subglandular. Committing to a cup size can be disappointing. The size may be smaller than you are expecting -- it's not easy to know what you think a full C cup is. I do however think that the size you've been suggested will look great on your body. It is a very tasteful size... more

Breast Implants Position

The term 'sub-pectoral' or 'sub-muscular' is somewhat misleading, as implants placed under the pec major are only partially covered by the muscle. The pec major covers the upper/medial half of the breast area, so a 'sub-pectoral' implant is truly subpectoral only in the upper and medial aspect of the augmented breast, while the lower and lateral aspect of the implant is actually in a sub-mammary position. Because sub-pectoral implants are, in reality, both... more

Michael Law, MD

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Raleigh-Durham Plastic Surgeon

michaellawmd.com

Breast implants should be placed under the muscle

Most surgeons would advise against placing breast implants above the muscle. The opposite is true; most surgeons place breast implants beneath the muscle. This is performed for three basic reasons: 1. By placing the implant beneath the muscle, the muscle camouflages the implant to some extent so your breast looks more natural and less circular. 2. The second reason is that it is easier for a radiologist to read a mammogram when it is below the muscle. 3. The third reason is that it... more

All implants need coverage, only some need muscle coverage

I perform both subglandular and submuscular breast augmentation and can get very nice, natural results with both approaches. As you can see from the other answers there are a lot of variables that are taken into consideration when performing breast augmentation. For a lot of reasons including appearance, tissue coverage of a breast implant is important. If you have enough native breast tissue, this may be enough to cover the implant. If not, the muscle will add a layer of coverage. From... more

Breast implants placed under the muscle will look and feel more natural

Unless you have a sagging breast, the submuscular approach will fell more natural if the operation is a success.The high profile implants look less natural than low or moderate profile plus implants.Seek a second opinion.See before and after photos of breast augmentation.

Most implants go under the muscle today

Over the years implants have been placed above and under the muscle among other combinations of the two. Currently the dual plane technique is the most commonly uses - this where you place the implant below the muscle but the lower portion of the muscle is released surgically to give a more natural appearance. There are only a limited number of indications for going above the muscle. The muscle will not "die" as suggested by the consultant you saw. A natural appearance also... more

Over or Under Muscle

I definately think that you would happier with implants placed under the muscle from your description of your body size. I, like most other plastic surgeons of my generation, placed most implants over the muscle in the mid80s to mid90s. Since then almost all of my patients have had their implants placed under the muscle. There definately is a more natural appearance, but there is a bit more pain and discomfort early on.

It is better for an implant to be under the muscle

Having your implant inserted under the muscle is better for two main reasons. 1. The muscle provides an additional layer of coverage for the implant. This helps make it more difficult to see or feel the edges of the implant. 2. Research has shown that women with implants under the muscle have a lower risk of capsular contracture. This is a condition in which the scar around the implants becomes hard and thick. One reason to put the implant above the muscle is because some think that it... more

Under or over the muscle for breast implants

In most cases, under the muscle gives the best results. The muscle does thin out, but it does not "die." However, the muscle gives an extra layer of your own tissue covering the implants. This makes it even less likely that you will be able to feel the implants.

Breast implant placement depends on the patient

I would agree with Dr. Jejurikar's response above. Anatomically speaking, breast implants above the muscle are more "natural", as there is not any breast tissue normally underneath the muscle. However, most surgeons currently prefer submuscular placement. This is a question that comes up often and there are pro's and con's of each approach. One approach is not always better than the other. Both have their places. A thorough consult should help you determine which approach is best... more

Muscle will not die with the use of submuscular implants

Without question the muscle over a submuscular implant will not die. We have all re-operated on patients with submuscular implants and the muscle is always active and viable. In my experience I tend not to use a textured implant above the muscle in a thin patient. These implants tend to have more palpable edges and ripples that, in the thin patient can be more noticeable. As far as a natural appearance there will always be debates about this issue. I agree that in my opinion behind the... more

Subglandular versus submuscular

Different surgeons have different approaches to breast augmentation, but virtually all of us would agree on a few points: 1) Submuscular implantation of muscle does not cause the muscle to die. The muscle does thin out and get stretched, but it certainly remains alive. 2) A 260 cc implant will not allow you increase 2 full cup sizes, from an A cup to a full C cup. 3) With the earlier generation textured silicone gel implants, submuscular placement was shown to result in less capsular... more

Over or under the muscle

Implants in a very thin patient should probably be placed under the muscle to give the most natural results. This will give more soft tissue coverage in the upper pole.