Has anyone ever had issues with silicone implants under the muscle on an extremely bony chest? (Photo)

I have a VERY boney chest with a very very minor Pectus excavatum. I am considering implants under the muscle, but am worried because of these issues combined with the fact that I have very little muscle and skin or "meat" on my chest. I have seen girls with similar chests have good results, but I still feel like I am way more boney than them and am worried that there won't be enough tissue or muscle to hold my implants in place. Any help or advice would be greatly appreciated!

Doctor Answers 7

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon


New York Plastic Surgeon
5.0 out of 5 stars 78 reviews

Implant Edges Might Be More Visible in Thin Women

Hello Tiny Texan,

I have not seen problems with silicone implants in thin women.  Yes, you are thinner than most.  I would recommend a partially subpectoral placement to hide the implants a little.  Smaller implants, rather than very large ones, will be less likely to have visible edges.  The muscle does not hold the implants up.  I would talk with your board certified plastic surgeon about pros and cons of silicone smooth versus textured vs anatomic to get an idea of your best option.  Best of luck.

D'Arcy Honeycutt, MD
Bismarck Plastic Surgeon
4.6 out of 5 stars 21 reviews

Breast augmentation with implants

Best to gain a little weight. Implants will help and can give you cleavage, better under the muscle. See a board certified ASAPS plastic surgeon. Good luck...

Larry Weinstein, MD
Morristown Plastic Surgeon
4.9 out of 5 stars 11 reviews

Thin women and implants

based on your photos and statements. I think you will have a good result with an augmentation. With the proper plane technique and implant selection, the visibility of your ribs may also be diminished. Several considerations should be addressed when you discuss with your surgeon with an in-person consultation. 

Hope that helps and best wishes!

Dr Morales

ABPS Board Certified Plastic Surgeon

Houston, TX



Rolando Morales Jr, MD
Houston Plastic Surgeon
5.0 out of 5 stars 25 reviews

Has anyone ever had issues with silicone implants under the muscle on an extremely bony chest?

Thank you for the question. Although I understand your concerns, I think that you have a very nice outcome with breast augmentation surgery, assuming careful selection of plastic surgeon, careful communication of goals, and careful execution of the procedure.


Generally speaking,  I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 


On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.    Best wishes for an outcome that you will be very pleased with.

Implant coverage

You indeed are very skinny!  The placement under the muscle is meant to cover the implant in order to help protect it, and to add an extra layer of thickness for coverage, so that the edges don't "show".  However, in you, that might not be quite enough.  I would probably suggest two other things: 1) using a Natrelle Inspira implant, which has a higher fill rate and thus less chance of showing wrinkling or the edges, 2) adding some fat grafting from the belly or thighs (wherever we can get it) to add a little volume in the skin medially and superiorly, to help make a smooth transition from the implant to your chest wall.  

Bony chest

Thanks for the great question and the photos. Just because you're thinner than some other patients does not mean you will not be able to get a great result from your augmentation. The only thing with you is because you don't have much breast tissue, the outlines of the implant may be slightly more visible compared to someone else with a little more breast tissue. Placing the implant under the muscle is good for you because it will help camouflage the implant. Best of luck!

~Dr. Sieber

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.