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.


This is a tough decision. As a fitness instructor, over the muscle might be more practical. Eight years ago, I went under the muscle as my mother is a breast cancer survivor and I wanted to make mammograms a bit more simple as you mention. However, many women seem to be getting silicone these days. And, women with breast implants are very good about doing self exams for early detection. Let us know where your research takes you. Thank you for sharing on RealSelf!

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Hi, Im very active had 3 children with emptier and more droopy boobs than you. I am a uk size 8 with 32C/B bra pre op. I am post op day 5. I had 375cc round implants place above the muscles. I really don't think you want to go under the muscle as when you do and are slim, when you lift anything heavy your breasts part. Looks very weird. I am very happy with them at the mo. have a look at my profile. If you would like to know more or see more pics just ask xxx good luck!
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            you def. have enough skin to cover the implant if you decide to go over the muscle; plus your healing will be alot quicker: your breast will probably drop faster since you dont have the muscle holding it up! they will be softer and you probably wont have to massage as much as oppose to being under the muscle;i think your in a better position off not getting cc with is a plus: if you want upper pole fullnest ypu shpuld go with a high profile implant; thats what i did and i got alot of upper pole fullnest but im under the muscle;
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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?

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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.


Altho not a fitness instructor I did breast feed and I workout with weights, do TRX and spin. My breasts looked very similar to yours- essentially empty with some sag but adequate tissue. I was a small 36B. My DR was going to go above the muscle but when i told him i definitely wanted some upper pole fullness he changed to the dual plane and i am very pleased with the results. I am only 4 days post-op but I think because I am in good shape I have had minimal discomfort and have essentially full range of motion in my arms. The most difficult thing for me is and will be forcing myself to take it easy and to fully heal before starting to work out again. As far as animation- I also do not consider that an issue and I believe you like me have plenty of breast tissue to cover most of the movement that might be caused when lifting weights. I hope this is helpful and Good Luck! Oh I received 400cc silicone mod profile but I am also taller than you-5'8, 140lb Let us all know what you decide.
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Thank you, BethH! This site has been so amazingly informative and reassuring already. Being able to read so many women's experiences and see their photos has been tremendously helpful and everyone is so supportive!
Thank you, Rachealuk! I hope I'm not going too small by going with a 286cc??? I'm a size 0/2 in clothes and my PS measured my breast width, which was almost 11cm so he suggested I go with the 286 so that I don't end up with implants wider than my own breasts which could look weird. But I'm concerned I won't have enough fullness, especially with all of the droopiness I have. I was told the rice test isn't accurate. I noticed by reading your profile that you did the rice test. Did you feel like it gave you an accurate idea?

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.


Glad to hear you are finding RealSelf helpful! You are now helping others by posting your review and comments. I agree with your decisions about type/size/placement of your implants!

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.


So you should be happy! You are a perfect description of me, I'm 5'4.5", 105lbs (approx as we go in kgs in Oz), I'm a droopy B cup and my PS has recommended sub glandular silicone. I've sort of decided on 300cc but yet to fully decide. Yours look so natural, your PS did a wonderful job! What cup size did 286cc bring you to?
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MTBN we are in the same boat, except I weigh a bit more than you- 125lbs.
I have a very narrow ribcage so I've been fitting into size 30DD or 32D bras. I sometimes wish if gone just a little bit bigger but I think everyone feels that way. It's kind of like diamond rings. Once you get one, you're so excited and then you wish it were a little bigger. :)

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. :)


Thanks very much ;)
Dr Craig Creaseman

5 out of 5 stars Overall rating
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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
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
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