How Do Saline Breast Implants Look if Placed over the Muscle?

The look of implants - either saline or silicone - is dependent on your overlying skin. If you are able to pinch a significant amount of skin (more than 2 cm) then you may do well with subglandular (over the muscle) breast implants. Otherwise, you may do better with submuscular implants which would have that added coverage of the muscle tissue. Good luck with your surgery.

I typically do not recommend implants to be placed directly under the breast tissue unless a previously placed submuscular implant is causing problems (scar contracture, etc.). Their are surgeons who will place implants under the gland to compensate for dropping/ sagging tissue...I think this results in an elongated (rock-in-sock) appearance that I personally do not care for...But I have heard patients say, when you see 10 different plastic surgeons, you may get 10 different opinions on what needs to be done.
So, see as many surgeons (Board Certified Plastic Surgeons) as you feel comfortable with, review their results, above and below the muscle, and evaluate what results most exemplify your goals and go with that surgeon!
I hope this abbreviated response helps!
Dr. C

Breast implants placed over the muscle will have less distortion by the muscle, though the upper part of the implant will likely be noticeable. It can give a somewhat "unnatural" look and feel, though this depends on how much native breast tissue you have. Advantages include easier recovery, less implant movement with muscle contraction and maintenance of muscle strength. It is a valid option in the right patient.