Do Breast Implants Need to Go over the Muscle if I Have Loose Skin?

I'm 25 yrs old and i have two kids. I'm about a big b/ small c. My doctor is saying i have to go over the mucsle cause of my loose skin. One measured 21 and the other measured 23. I'm very scared and nourves to do over the mucsle cause of everything i've heard. Please help me with this fear.

Doctor Answers 10

It is a matter of anatomy

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 It sound like based on your measurements you made a minimal lift.  Over or under the muscle depends on whether you have enough breast tissue to camouflage the implant.  visit with your surgeon and ask his/her reasoning for going on top of the muscle.

Good Luck

Dr. ES

Do Breast Implants Need to Go over the Muscle if I Have Loose Skin?

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You can place the implants under or over. However one more popular approach is the dual plane technique which allows benefits of both positons.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Loose skin and pocket

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Just because you have loose skin does not mean they have to go anove the muscle. They can go below.  If they sag you need a lift.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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Breast implants have to go over the muscle to correct sagging.

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Trust your plastic surgeon or go somewhere else.  Breast implants have to go over the muscle to correct sagging.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Implants need to go over the muscle if I have loose skin

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NO! You most likely need a lift with the scars. But you failed to post photos so it is a guess on my part. Seek 3 opinions in person from boarded surgeons oin your area.

From MIAMI Dr. B

Implants Under the Muscle Work Better

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A recurring theme among some plastic surgeons is an attempt to take up loose skin by placing the implants on top of the muscle.  This takesup a little more skin, but in the long run, the breasts will just sag more and can provide that " rock in a sock" appearance to the breast.  Underneath the muscle will help hold the implant betterand  provide better coverage.  It may require a small lift in conjunction, but ia a better option in my opinion.  I hope this helps.

Implants under muscle for coverage, lift for loose skin

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You will notice a theme in the responses to your question, in that going over because of loose skin is most often not the best solution. Not only might you have inadequate implant coverage, leading to a fake look and feel, but the long-term tendency in those cases is for the weight of the implants to continue to stretch the skin leading to a "rock in a sock" look. Skin laxity needs to be corrected with a lift, and the decision about over or under is based on whether coverage is adequate, not the laxity of the skin. Since you are asymmetrical in terms of nipple position, the lift would be needed anyway in order to equalize.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Over or under the muscle breast implants

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It is a big mistake in my opinion to try to correct loose skin with implants over the muscle.  This will lead to a matronly ball in sock look that will make you look old.  The better plan is to go under the muscle with the right size implant (not too big) and do a lift to tighten the loose skin.  

Trying to correct loose skin by over the muscle augmentation

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I agree with Dr. Alsea. I think too many patients who really need a lift of some type have above the muscle breast augmentation in an effort to take up loose skin. I realize that many women do not want the additional incisions/scars/costs but they need to reralize that they may very well be unhappy with the results and request a breast lift in the future in addition to needing to have the implants placed partially under the muscle. Realize that every case is different and these decisions should be made between the plastic surgeon and patient.

I hope this helps.

Dr Edwards

Sagging,Flat Breasts benefit from a Breast Augmentation Lift

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You do not "need" to have implants placed over the muscle. No one does.  Doing so will marginally decrease the amount of breast skin that needs to be removed BUT will leave a visible and highly palpable implant.

You would probably do best by having a Breast Augmentation with a Lift. I would recommend you consider gel implants (which are lighter and which ripple less than saline implants) and have them placed UNDER the muscle. The cosmetic result and its durability would be vastly superior DESPITE the breast lift scars.

Peter A. Aldea, MD
Memphis 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.