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

Hello, I think that in your case you can easily place the implants above the muscle and they will look very good, as a drummer it is a very good option, remember to rest for at least 6 weeks

Depending on the size of the implants selected, it appears you have adequate tissue to allow an acceptable aesthetic outcome OTM, There are other advantages to going under the muscle and this should be discussed with your surgeon during a consultation.

Over the muscle is more anatomically correct and does avoid any implants issues with flexing, etc.

There is a slightly higher risk of form scar tissue or capsule and fold support, but you appear to be a good candidate for implants over the muscle.

Over the muscle gives a more natural look and can “lift” the breasts better than under the muscle.

An exam and consultation with a plastic surgeon is recommended to confirm as well as discuss your options and expectations.

Dear RealSelfMember0998938,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

It depends on the thickness and density of your breast tissue where it blends with your chest along the upper breast boarder. Generally speaking, if your pinch test in this location produces a skin-to-skin thickness of 2 cm or more, you are a candidate for breast augmentation on top of the muscle. Sientra textured anatomic implants work exceptionally well for women with your breast shape when placed in the sub facial position (under the connective tissue on top of the muscle). Textured implants may not be as safe as smooth implants. You should have a detailed discussion with your surgeon about the merits of each implant type before making your decision. Best of luck!

One good option would be to place the implants under the pectoralis fascia, which offers some benefit over sub, glandular augmentation, and does not have associated animation deformity

Yes, you appear to have enough breast tissue to go over the muscle. However, implants in front of the muscle cut the nerves to the nipples. Also, your breasts asymmetrical in volume, shape and position. I recommend you have a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, small implants can be placed.

Best Wishes,

Gary Horndeski, M.D.

I would always recommend placing the implants below the muscle due to less problems over time including less implant rippling/show, lower rates of capsular contracture, and less compressive forces on the breast tissue/skin. I recommend finding a board-eligible or board-certified plastic surgeon with experience in breast augmentation.

If it is your desire to go over the muscle I think that would work just fine. You sissy’s have options and I think in your case it’s totally reasonable

Thank you for your question and photos. An examination in person would be required to properly address your question but based on your photos it appears that you are indeed a candidate for a subfascial (my preferred approach) or sub glandular augmentation. I agree with your concerns regarding animation deformity which can be very unpleasant for women.

Please consult with a board certified plastic surgeon specifically experienced in subfascial breast augmentation. Best of luck to you.