How do I choose between over muscle and under muscle? (Photo)

Choosing the right procedure for breast rejuvenation can be complex, especially with the varying recommendations you've received. Here are a few key considerations to help guide your decision:

1. Breast Lift (Mastopexy): Given the significant sagging present, a breast lift is the most beneficial portion of the surgical plan. This procedure can correct the sagging by removing excess skin and reshaping the breast tissue, which will provide substantial improvement in breast appearance.

2. Implant Type (Silicone vs. Saline): Silicone implants are generally preferred for their more natural feel and appearance. They are also less likely to cause rippling compared to saline implants.

3. Implant Placement (Over vs. Under the Muscle): Placing implants under the muscle is favored for several reasons, including a lower risk of capsular contracture (a common complication where scar tissue forms around the implant), better imaging during mammograms, and often a more natural appearance.

4. Long-Term Considerations: Implants are not lifetime devices and will likely need to be replaced at some point. Considering your age, this is an important factor, as any subsequent surgeries will be undertaken when you are older.

5. Alternative Options: If you're uncertain about implants, you might initially opt for just a breast lift and then assess your satisfaction with the results. If more fullness is desired afterward, you could consider a second procedure for implants or explore fat grafting for a more natural enhancement.

Finally, choose a surgeon with whom you feel comfortable and who understands your aesthetic goals. A third consultation with another experienced surgeon might also provide clarity and help solidify your decision.

If you are getting breast augmentation with breast implants, the implant will be placed behind the chest muscle in most cases. There are a few exceptions where the breast implant is placed over the chest muscle due to the activity level you may enjoy.
At NorCal Plastic Surgery, we use gummy bear implants, which are smooth, round implants that will enhance the appearance of your natural breast, safely. They are among the safest and most commonly used implants for breast augmentation.
Breast implants do not cause breast cancer or any other systemic diseases. Numerous studies have shown no difference in survival between augmented and nonaugmented patients with breast cancer. Studies have also shown you may continue your recommended breast cancer screening with mammograms or any other technology recommended by your primary care physician.
There are also a few options for placement of the incision, such as under the armpit, along the border of the areola, and under the breast. During your initial consultation, we will determine implant placement and incision type.

Hi there. Thank you for your photo and question. I have included a video to describe the difference. Hope this helps to answer some of your questions. Best of luck!