Do I have enough breast tissue to go over the muscle? (Photo)

Hi. To appropriately discuss implant size, location and choice, you really need an in person evaluation by a plastic surgeon with good experience with breast augmentation. Opinions and preferences will vary somewhat from one surgeon to another surgeon. Personally I start with the base width of the patient as the starting point for the footprint of the future implant. Tissue characteristics, and desired postoperative size, and patient anatomy all factor in to the proper selection of implant volume as well as profile. In a similar fashion, pocket location (above or below the muscle) choice can vary from one surgeon to another but ultimately is based at least in part on your anatomy and how much tissue you have to camouflage the implant. It is a balance of pluses and minuses with each location. Putting an implant above the muscle with thin coverage can result in visible rippling or seeing the implant in an undesirable way. Below the muscle might have a different sensation when you are working out but most women tend to tolerate that very well. You will also tend to have a little bit of movement when you flex the chest muscle when the implant is under the muscle, but again that tends to not be a significant issue. I go over all of that all in detail with my patients at the time of their consultation.
I would recommend consulting with a board-certified plastic surgeon with good experience in this area. He or she can thoroughly review the options with you so that you can make a good and well-informed mutual decision.

Hi, thank you for sharing your question. You are a great candidate for breast augmentation and based on the photo, over the muscle should be possible. The exact size will depend on measurements taken by your surgeon. I hope this helps.

Thanks for your question. You may well have enough tissue to adequately cover an implant in the sub glandular plane (over the muscle). A face to face consultation with 3D simulation would enable an individualised recommendation of an implant with the appropriate dimensions and volume to achieve your goals.

Dear Affectionate299366
Many thanks for your question and photo. Of course you need a consultation and clinical examination but just by looking at your photo, I think you would be good candidate for implant over your muscle.
As a rule as long as you have about 2 cm thickness of soft tissues of your breast upper pole , you may be able to put the implant over the muscle. You can check for that yourself by pinching the soft tissues of the upper portion of your breast between your thumb and index finger and check to see if it is more than 2 cm. as I mentioned, there are other factors also involved that is why I recommend you have a consultation with a GMC registered plastic surgeon but I hope you find my explanation helpful. Good Luck!

Dear Affectionate299366,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question and photos. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon, but from your photo it appears you are a Volume (300 versus 400), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. The 350 n excellent candidate for a subfascial augmentation. For a person such as you with a petite frame you will require a narrower diameter implant than a patient with a broader chest or larger frame. Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

HelloThank you for the question. Yes, the implant can be positioned behind the breast tissue. Different factors contribute with Implant visibility including thickness of the breast tissue, size of the implant and after care such lack of support in a bra.

You probably have enough tissue for implants over the muscle, but an examination is needed to be sure. You might need to go down a little in size, or the edge might be noticeable.

Though an in person evaluation is always best, from your photo it appears you have enough breast tissue to place the implant above the muscle. I encourage you to schedule a consultation with a board certified plastic surgeon near you to discuss your concerns. You'll learn about the pros and cons of over versus under the muscle. Implant selection will also be discussed.

Greetings,
The best way to answer this question is for you to seek out a plastic surgeon(s) who peforms augmentatons both above and below the muscle. As you have likely found out, there are advantages and disadvantages with placement above the muscle. Your plastic surgeon can examine you and provide you with guidance for implant size limitations when the implant is in front of the muscle. You must have adequate breast tissue to cover any subglandular breast implant. Your size selection must not exceed the ability of the breast tissue to well cover this implant.
Best Regards,