Can I get a good result from a over the muscle, silicone gel, Breast augmentation? (photos)

I am trying to avoid a breast lift scar if possible? I've had 3 different opinions from 3 different PS leaving me confused! I don't want to have to go through an additional surgery if I'm not satisfied with the "overs".

Doctor Answers 23

Adding an Implant and Lifting Your Breast

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I understand your desire to avoid scarring, but consider that without a lift, your apt to be left with a disappointing result. Your degree of breast droop would be treated well with the lift. Using a huge implant to artificially attempt to "lift" your breast will leave you unnaturally augmented and your breast anatomy thinned as the years pass. I'd trust the advice of a plastic surgeon certified by the American Board of Plastic Surgery that is recommending a lift and augmentation. Your consultation can clarify details further. 

Can I achieve a good result with an Augmentation above the muscle.

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I personally do not think an implant will make you happy. Your breast is stretched out and the only way to achieve a beautiful result is a Mastopexy and an Implant . Wishing you all the best. That operation is the hardest we do in our field ,so make sure your surgeon is very comfortable with the operation . It can be done in 2 stages or 1 stage

Neumon T. Goshorn, MD
Memphis Plastic Surgeon

Breast Lift

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In my opinion, you would have a long term result from an augmentation with a lift. I wouldn't treat you with a Breast Augmentation alone. Of course, you should discuss with your PS and come up with the best solution whcih will depend on the look you'd like to achieve. 

Daniel Barrett, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 85 reviews

Can I get a good result from a over the muscle, silicone gel, Breast augmentation?

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A breast implant alone would be a totally inappropriate choice with so much drooping of the breast tissues and a total waste of your money. Without a lift you will not have a pleasing result. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Can I get a good result from over the muscle implant

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In short , you will be unhappy with any implant only approach to your situation. This comes from over 20 years of experience doing this and attempting many times when I was a young and inexperienced plastic surgeon to meet the desires of patients with droopy breasts who did not want a scar using only implants and even developing new techniques endoscopically to accomplish that goal. I even traveled and presented these techniques and taught them to other surgeons at national and international meetings. However, I rarely do them now because, of the ones I did ,several of them eventually came back and said they wished they had just gone with the lift and implant as opposed to the implant alone. As I grew in experience in practice I realized that the bottom line is that patients want the most beautiful shaped breast they can get which is comfortable ,and a beautiful shape with the option to make it any size they want is far better than compromising and making an aesthetically sub par breast that is usually larger and heavier just to avoid the scar ( which actually is quite forgiving). We go through an extensive process to be sure each patient has the opportunity to determine what size they want to be and we go into all the pros and cons of implant types and shapes and fit the implant to the individual patient. 
I wish you all the best and if we can help you let us know.

Grady B. Core, MD
Birmingham Plastic Surgeon
4.6 out of 5 stars 13 reviews


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Thank you for your question and pictures.  Over or under, I feel that you will need a lift along with the implant unless you are willing to accept the natural droopiness of your breasts.  Even with the implants above the muscle, the breast will not be fully  lifted.  And please do not fall into the trap of picking a much larger implant than you wanted to try to lift your breast and avoid scars.  Not only will it not work, but you will be left with a much larger breast than desired which by weighing more will have a greater risk of falling more sooner than later.

Ramiro Morales, Jr., MD
Pembroke Pines Plastic Surgeon
4.6 out of 5 stars 28 reviews

Breast augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/Silicone Implants/Revision Breast Surgery

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I appreciate your question.

From your photos, it appears that you would benefit most from a breast lift to reposition your nipples and reshape your breasts, giving them a more youthful appearance.  Along with breast augmentation if you more volume is your desired result.

The best way to determine implant size is based on chest wall measurements that fit your body. Once we determine that we can choose the profile based on what you want or need to achieve.

With Implants under the muscle, there is less risk of capsular contracture. Anatomic implants tend to give a more natural shape with more nipple projection.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute

Needs a lift

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From your photographs, in my experience any implant whether in the dual plane or just under the gland will not correct your breasts droopiness. A vertical or lollipop type lift, with or without a silicone gel implant will be necessary to achieve a youthful breasts with the nipple lined up with the center of the implant. I'm sure can be confusing to have three different opinions but plastic surgery, being an art, there is not one sure way to fix anything. Find a board-certified plastic surgeon in your area of experience in cosmetic breast surgery. If you can find someone with a Vectra 3-D imaging system, they can show you, on a 3-D image of yourself ,what the effect of just an implant versus a lift and an implant would look like. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Too many answers

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It must be very confusing to you that you get so many opinions.  The reason is that there is not one correct answer.  Your surgeon must take into consideration not only the standard answer to the challenge but must listen to your desires and provide you a series of choices to meet your goals.

When a patient says "I don't want the scars of a lift", I will provide alternatives that will avoid the scars even if I do not see those choices as the best overall solution.  Your job is to listen to the alternatives and see what works best for you.  If your goal is to have perkier, lifted breasts, then it will require a lift.  If you just want the breasts fuller, you can consider a over the muscle augmentation with the understanding that it is a compromise that will fill in the breast but not provide any true lift.

I'm sorry that we confuse you with our multiple options.   I wish you the best sorting through the answers.

James D. Frost, MD
Pensacola Plastic Surgeon
4.9 out of 5 stars 10 reviews

Can I get a good result from a over the muscle, silicone gel, Breast augmentation? (photos)

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Thank you for your question and photographs. Unfortunately I think you will not obtain a satisfactory result with only implant placement. You have a moderate amount of breast sagging and excess skin to your breasts that will not correct itself with implants alone.A lift will correct both of these problems while also placing your nipple and areola into an elevated more youthful position and improving your shape and contour. Hope that this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.