Fitness Instructor with Mild Ptosis...Over or Under the Muscle?

I'm 41 y/o, 5'4" and 110lbs. My pre-surgery bra...

I'm 41 y/o, 5'4" and 110lbs. My pre-surgery bra size is a 32B. I want a natural enhancement that mostly just restores my lost volume so I'm considering 286cc silicone. My PS suggested I have them placed over the muscle (Subglandular) due to my profession as a fitness instructor. He is concerned about animation with Submuscular placement and feels I have adequate tissue to cover a silicone implant nicely. I'm concerned that Subglandular implants might look matronly as they tend to be bottom-heavy. I trust his judgement but I do want to get some other opinions. I don't think animation is as big of a concern to me as the higher risk of capsular contraction, difficulty with mammograms, visibility of the implants and matronly looking (bottom-heavy) breasts are. One of my primary goals is to achieve more fullness in the upper pole which from what I've seen online is achieved well with a dual-plane approach (partial under the muscle). Bottom line is I've having trouble deciding whether to go over or partially under the muscle. Any other super fit, active women with mild drooping after breastfeeding have any opinions about going over or under the muscle? I've included my before photos.

What size should I go with?

I have a very narrow ribcage (28-30") and my breast width was 10-11cm. I have weighed out all of the variables and decided to go with Subglandular silicone implants. I am now trying to decide what size I should go with. My doctor likes the Natrelle moderate profile 286cc for me since the width matches my frame best and I have a fair amount of breast tissue already but I've been reading so many comments of women saying they wished they'd gone bigger. Is 300cc or 330cc too big for someone like me?

Ideal Shape

I really want to have a nice gradual slope, not overly round on top with some fullness in the lower pole and nipples that point forward and not downward. As someone else wrote (can't remember who) "a natural look with a little wow factor!" I would like to be a full C-cup. I've always been a small B and now I'm a droopy, barely B.

Rice test

I did the rice test today for 286cc and it felt plenty big enough. I think my doctor chose a good size for me. I'm feeling really good about it and starting to get very excited! Just one month to go till I lose these National Geographric puppies.

Sub-glandular 286cc Silicone (over the muscle)

I am so happy I trusted my doctor and went over the muscle. I had mild ptosis and he suggested going over the muscle for various different reasons that I've mentioned in my previous comments. I now have very natural looking, filled out breasts with great cleavage and they I don't get any animation or distortion when I exercise, which is all of the time. I'm very petite, so we went with a small size, just enough to fill out the lose skin and stay proportionate to my body. My doc isn't into "putting cantaloupes on an ironing board" his words. I'm very happy.

3 months post-op photo

Silicone 286cc moderate profile sub-glandular placement. My goal was to have very natural looking, fuller breasts with a little wow factor. I think my doctor achieved my goal. :)
San Jose Plastic Surgeon

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
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