Are low profile saline implants over the muscle too noticeable?

Thank you for your question.  Generally saline implants above the muscle are less favorable because of the scalloping and ripples that can be see or felt.  It does all depend on how much soft tissue coverage you have though (how much breast tissue).  You cannot likely find many photos because it is not often done.  Best advice is to go to a few consultations with board certified plastic surgeons who can examine you and determine the best plan for you. 

Visible rippling can be improved by placing the implant under the muscle, switching to silicone, fat grafting to the breast, or the addition of a dermal matrix. Breast implants placed over the muscle appear more artificial in patients who begin with small breasts, mammography is slightly less accurate when the implant is above the muscle, and the capsular contracture rate is higher. Most of my patients prefer moderate+ silicone breast implants.

Hello and thank you for your question. It would be useful to see your photos. Unless you have significant amount of breast tissue/subcutaneous fat, saline implants above the muscle have a higher tendency cause problems with visibility and rippling. Advantages of 
submuscular placement of the implant is less likelihood for capsule formation,
more natural look and less rippling/implant visibility. As there is a
layer of muscle separating the implant from the breast tissue, there will also
be less interference with mammograms. Animation deformity is a known side
effect of submuscular implant placement, which is not very noticeable in
clothing.  Animation deformity is more noticeable is
thinner individuals due lack of adequate coverage of the implants.
Best
wishes and good luck,
Pejman
Aflaki, M.D. Johns Hopkins-trained double board-certified plastic surgeon
 

Hi.  I would be very hesitant to place a saline implant over the muscle because they do not tend to look as natural and are more likely to show rippling when they are placed above the muscle.  If you do not have adequate tissue in the upper portion of the chest to help camouflage the implant then you will likely see rippling and the edge of the implant which can be visually unappealing.  I would recommend consulting with a board certified plastic surgeon with good experience with breast augmentation to go over the risks and benefits and pros and cons of various different approaches.  Good luck and take care, Dr. Howell

Hello, thank you for your question and provided information as well..
Based in your question, I dont recommend saline implants anymore, since they last less (6-7 years only). I recommend silicone implants, for a more rounded and natural look, you could achive this look if you consider breast augmentation sub muscular. 
Know that 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.   
Best of lucks.
Dr. Luis Mejia.

I suggest doing 3D imaging which you can do online from your home.  You can use the technology to control for breast implant volume, shape, and profile.

Saline implants over muscle is almost never a good idea. The look and feel of saline is much less natural than silicone and there is very likely chance of seeing wrinkles. Placing saline under the muscle improves the look and feel a lot but still sometimes the implant can be felt or seen laterally or inferiorly where it is less covered with muscle. This is one of the reasons most patients choose silicone. If you definitely want saline, no matter the profile, I would recommend under muscle. Good luck.

Low profile saline implants are not used frequently as they are more prone to rippling and are rather flat.  Going over the muscle may not be the best idea if you are trying to achieve a natural look.  There are several advantages to being in front of the muscle, which is why most surgeons advise against it.  You can get a very natural look with a plane approach.  A dual plane placement of the implant will take advantage of having the implant behind the muscle but still have the inferior portion behind the breast tissue to give a very nice shape to the lower pole of the breast.As far as the type of implant, the majority of the country has switched to silicone implants are they are simply a "better" implant.  They feel more natural, decrease the rippling and camouflage better than saline implants.Your best approach would be to find a board certified plastic surgeon to evaluate you and help you determine what is the best approach to your augmentation surgery.Hope that helps.

Dear Polite5245,
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

Hello and thank you for your question. There are several advantages and disadvantages to over vs under the muscle.  Under the muscle has the advantage of lower capsular contracture rates, less risk of rippling, and better visualization with future mammograms.  Most patients say that under the muscle also has a more natural look and feel.  The size, shape, and profile 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.  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. Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon