Above muscle to below muscle breast augmentation; does breast tissue compress w/above muscle implant leaving less volume?

Question

In 2011 had breast aug below muscle w/Natrelle 300&350cc silicone implants. Retrospect should've gotten a mastoplexy w/no implants. Live and learn. Went from C cup to DD. Hated how big they were. 2021 had implants taken out, requested smaller - surgeon placed above muscle 300&325 Mentor moderate plus profile w/mastoplexy. Still a DD. Hate size & profile. Now Surgeon says mastoplexy w/below muscle Natrelle low/low+ 230cc's bc w/o implants belief cup size will be B bc of compressed tissue.

Gary M. Horndeski, MD · Answer

Back in 2011 when you had a breast augmentation, you really needed a mastopexy as well and you still do.  Unfortunately, you have not provided photographs.  However, at this time, I recommend explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear KMAMK,
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

Larry Weinstein, MD · Answer

I wonder how you decided on the implants that have been used for your breast enhancement. Did you have Vector computerized imaging before your first surgery? Did you try on implants in a tight bra? Did you see before and after photos of someone with a similar body to your self? What is your breast diameter relative to your waist and hips? photos of your current look would help with a possible recommendation. Good luck. Happy holidays...

Connie Hiers, MD, FACS · Answer

Typically, each 150 cc' s of implant volume adds a cup. If you have 300 cc's and are a DD, you may be a C with implants removed. If you have a lot of sagging skin, you might even be a B once the lift is done. Do you still want implants? You might consider removal and a lift. Small implants could always be added later if you want more volume. Otherwise consider going down to 150-200 cc's to add a volume to your own tissue.

Above muscle to below muscle breast augmentation; does breast tissue compress w/above muscle implant leaving less volume?

Answers (4)

Answer: Size

Answer: Size

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Everything you need to know about Breast Implant Revision

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Above muscle to below muscle breast augmentation; does breast tissue compress w/above muscle implant leaving less volume?

Answers (4)

Answer: Size

Answer: Size

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.