Breast Implants and Mini Tummy Tuck...Under or Over Muscle For Most Natural Look?

I'm getting breast implants on March 26th and I'm not sure if I should get them over or under the muscle. I want the most natural looking and feeling look along with less risk of having complications. I'm thinking of having a mini tummy tuck at the same time and would 7 days be enough time off of work?

Doctor Answers 15

Over or under the muscle

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Thank you for your question. Typically, placement of the implant under the muscle leads to a more natural look. The added tissue coverage of the implant creates a more gentle transition of the superior pole of the implant. This avoids the shelf at the top part of the implant which I am sure you have seen in poorly done procedures. It also minimizes the risk of rippling and implant palpability.

As for the time off from work, it really depends on the extent of the mini-tummy tuck. If the muscles need to be tightened during the procedure, then you might want to consider a couple of more days off.

Best of luck with your upcoming surgery.

Jeff Rockmore

Breast Augmentation & Mini-Tummy-tuck

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For the most natural look, have your implants placed under the muscle.  This way, there is less chance to see or feel the implant.  There is also a decreased risk of "capsular contracture" or bad scar tissue that forms around the implant and makes the breast look un-natural.  It is difficult to advise patients about time off - everyone is so different.  Most people can return to a low-impact job at 1-2 weeks depending on your pain tolerance.  Good luck!

Where should my breast implant go?

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There are advantages and disadvantages to going under or over the muscle and each case needs to be decided based on you anatomy, budget, activity level or occupation.

Saline implants need to go under the muscle most of the time so that ripples and wrinkes don't show through at the upper part of the breast.  Its also easier to do your mammogram with them at that location and less likely that the edges will show. Generally saline implants are less expensive, too, (but may not last as long as a silicone implant).

  Regardless of the type of implant, if you are very thin, the implant will be covered best if it is under the muscle.  There is also slightly less risk of capsular contracture under the muscle.

 If you have some breast or body tissue to cover the implant it is not so important to go under the muscle.  The advantage is that the recovery is faster and more comfortable.  A natural look is possible if you use silicone.

Deborah Ekstrom, MD
Worcester Plastic Surgeon
4.7 out of 5 stars 39 reviews

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Breast Augmentation

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While it is possible to get a natural look with implants either above or below the muscle, I believe most surgeons feel that below the muscle gives a better chance in most women.  The idea of having more "padding" over the implant (ie. breast tissue and muscle) suggests less of a chance to see and/or feel the implant itself.  As far as your time off work, 7 days may cut it a little close for recovery from both procedures at once.  Take care of yourself and heal completely before you are too active.  I hope this information is helpful.

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon

Natural Looking Breast Augmentation and Time off Work post surgery

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Typically, under the muscle will provide the more natural look. Express your needs and objectives clearly to your surgeon so he can properly plan your surgery. Depending on the scope of work, you may return to light duties after 5 to 7 days. Your surgeon may restrict you longer depending on the scope of your work.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Under the muscle placement

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Hello. I recommend under the muscle placement for almost all patients. The under the muscle placement provides more support to the implant, reduces the risk of  rippling, and is more natural looking. 7 days would be enough time off work for a breast augmentation alone but with a mini tummy tuck it could be longer especially if your surgeon decides to plicate your abdominal muscles.

Jaime Perez, MD
Breast Augmentation Specialist
Plastic Surgery Center of Tampa

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 81 reviews

Breast implants above or below the muscle?

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Great question with different answers. In general, placing the implants below the muscle will give the most natural look and feel. This is definitely more true for saline implants. Silicone implants can do well above the muscle as well, but are slightly better below. As for time off after surgery, everyone is a little different. One week should be enough, but hard to tell. 

Asaad H. Samra, MD
New Jersey Plastic Surgeon
5.0 out of 5 stars 43 reviews

Under or Over Muscle For Most Natural Look?

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As always, the answers without benefit of photos will be of limited value!

Most surgeons think that under the muscle implants appear more natural and have a lower incidence of various complications, especially capsular contracture.

One area of exception in "animation."  Under the muscle implants move somewhat with flexion of the pectoralis muscles.

A week should be enough time off if your work in not exertional.

All the best.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Under or over the muscle

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Based on what you are trying to achieve, you should go under the muscle. It generally gives a more natural appearance, has less chance of capsular contracture, less chance of rippling in the upper breast, and better visibility on mammograms. As far as time off from work, it depends on what exactly will be done and your pain tolerance. Best of luck.

Paul Wigoda, MD
Fort Lauderdale Plastic Surgeon
4.8 out of 5 stars 30 reviews


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I prefer the submuscular implant position because the added coverage provides a softer look. The more procedures you have performed at the same time the longer your recovery will be

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

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.