545cc HP implant exchange. Is it best to go under the muscle with moderate plus? (Photo)

Good morning,
I think your plan is very reasonable- switch to a smaller implant, with less projection (Mod Plus), and switch to under the muscle for a more natural look and feel and better cleavage- perfect plan!

You will not get the finely defined cleavage, as shown in the example photo, with implants underneath the muscle. I recommend smaller implants and possibly consider fat transfer to soften the sharp edges and give you more medial definition.

Best Wishes,

Gary Horndeski, M.D.

Dear csmlove,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Going behind the muscle will give more upper breast fullness and help minimize seeing the implant edge. It is a more natural look for most women. I do agree with going with something smaller that will fit your frame and tissue better. You might consider 350-400 cc's with a moderate plus profile.