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

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 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.