Should I get a bigger implant over the muscle? (photo)

To make implant outcome more visible, you would have to go with a bigger implant or consider fat augmentation. Implants under the breast tissue and over the muscle may get more scarred and contracted which is what you see with Posh Spice above. The problem is as you go bigger in that plane, it puts more weight on overlying breast tissue and exacerbates sagging of the breast over the long term. Under the muscle is more often done, and is less associated with firmness from scar and holds up higher over the long term. You may want to consider a shaped cohesive gel implant of a larger size to give a fuller look, and these hold up better in a more superficial plane like you want.

Without photos it is hard to advise you.In my own practice we keep silicone gel
implants of all sizes available for patients to try on in a testing
bra. This is not a perfect teaching tool because under the muscle implants
tend to lose some projection, but because my patients look it actual implants
on their frame I find it the most helpful.I encourage my patients to bring a friend or
friends for a second or third opinion, and to bring a few different shirts.I suggest as you look at implants you think
about the relationship between the width of the breast and the width of the
shoulders and hips. Two wide will make you look top heavy, too narrow
will make the breasts look like torpedoes. I personally like to see the outer
curve the breast have balance with the curve of the hip.Once we hone in on the right diameter we then
look at the projection of the breast which changes the cup size. At the
correct diameter we can use a high moderate or low profile implant depending
upon the patients goals.Depending upon the starting situation, and the
degree of droop we adjust accordingly.Photographs of your goals are helpful, but
they don't always tell the whole story. They don't always let you know a
height and width of the entire patient.

if you like the look of Victoria Beckham,  you probably need either to get a larger implant or lose enough weight so that you look emaciated. whatever you do keep the implant under the muscle or you could incur many other problems

Your question is a very common one in my practice.  Here in Miami a lot of patients seek a larger, rounder appearance after their breast augmentation.  There are several ways to address your issue of more upper pole fullness that in turn will give you a less natural appearance.  The first way as you mentioned is to move the implant above the muscle. The down side to doing this is that you can increase the risk of creating capsular contracture (scar tissue around the implant that can feel firm) around your implant.  Secondly the implant is going to be more palpable and will feel firmer to the touch.  Another option is to change the implant you have to a higher profile implant.  Currently there is a lot of options for for breast implants and my simply changing the implant style it may help you achieve the result you desire.  This is a good discussion for you to have with your plastic surgeon.  Bring him or her pictures of what you would like to look like so that he can have an idea of what it would take to get the result you desire.  In my practice it is possible to give patients a full round appearance with the implant behind the muscle so I would not change the implant location solely for that reason.  I hope this helps.

Thank you for your question. Breast augmentation surgery is individualized to each patient. Breast implants are manufactured in a variety of shapes, sizes, and with either smooth or textured surfaces. The method of implant selection and size, along with surgical approach for inserting and positioning breast implants will depend on your preferences and your anatomy and previous surgeries. The shape and size of your breasts prior to surgery will influence both the recommended treatment and the final results. I tell all of my patients “Dimensions and proportions are the determinants of a beautiful breast; not volume.” I recommend that you make an appointment with a board certified plastic surgeon to discuss your breast augmentation options based on breast measurements and tissue dynamics.

If you have larger implants replaced I would definitely keep then in the existing  submuscular pocket. If you convert to on top of the muscle you will increase your chance of a capsular contracture and    the late occurrences of other issues such as implant "bottoming out", visible rippling, or the possibility of the appearance of "a rock in a sock" years later.

It would be best to be seen in person to be properly evaluated. To figure out how much larger you want to go to give your surgeon a rough idea, then do a baggy test.

Thank you for the question. There are so many advantages of breast implants placed “under the muscle”, that I would not recommend that you replace implants over the muscle. It may be possible, although difficult to tell without examination or viewing pictures, to use a larger breast implant ( for even overfilled saline breast implants) to achieve the rounder outcome that you seem to wish to achieve.  Be careful with your decision-making; weigh the pros/cons of each option carefully before proceeding. At this point, I would suggest that you have a full discussion/communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural”  or “D or DD cup”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.




Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.I hope this (and the attached link) help.