Over or under the muscle? (photos)

H! I am currently a small C cup. I have had 4 kids. Elected NOT to have a lift, people see my breasts a lot, and the scarring is not an option. I have had a few consultations and found a doctor I really like. He has told me 800ccs (Yes, I know that's huge) over the muscle, and lowering my mammary fold a tiny bit will give me the naturally huge look I'm looking for. Does that sound about right?

Doctor Answers 9

800 CC Implants

Thank you for your question. 800cc would be the largest silicone gel implant possible. It is a matter of personal opinion/preference what is a "natural" look. You should understand that the level of sagging you have may increase somewhat over time with large amount of added weight- especially over the muscle. I recommend that you discuss realistic expectations in detail with your Plastic Surgeon.
All the best

Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Over or under the muscle

a naturally large breast on a woman will be saggy, especially of the size you are describing. If you are willing to live with larger saggy breast, and in your opinion that is natural, then I think above the muscle without a lift is fine.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews


A very large implant over the muscle will eventually lead to skin sagging. Seek several other consults in your area 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 42 reviews

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

I appreciate your question. The best way to determine implant size is based on chest wall measurements that fit your body.  Once we determine that we can choose the profile based on what you want or need to achieve.   Implants under the muscle, there is less risk of capsular contracture.  Anatomic implants tend to give a more natural shape with more nipple projection. The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

Over or under the muscle?

It is never ever a good idea to go with a larger implant to avoid a lift. From what you describe that is exactly what the surgeon you saw is trying to do. Instead of a smaller droopy breast you will have a really big droopy breast. If you need a lift, you need a lift. If you can not stand the thought of scars, then maybe don't have breast surgery at all because what you have may be way better then just having huge implants placed. 

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews


A 800 cc breast implant may be too big, it all depends on your height and chest dimensions, but a larger implant does not correct a breast ptosis, even by lowering the infra mammary fold, and especially if the implants are too heavy (800cc) and the implants are placed above the muscle, then bottoming out of the implants in the lower pole is very probable and the results will also be poor and you will need another procedure. The scars for a breast lift in most of the patients are minimally noticeable, you should consider the options with the limitations for each particular procedure, a nice shape with some scars, vs a big breast without a nice shape.

Juan Carlos Fuentes, MD
Mexico Plastic Surgeon
4.7 out of 5 stars 65 reviews

Lowering the fold with large implants - is it a good idea?

I would be careful with lowering the fold with that large an implant, your risk of developing a double bubble would be extremely high.

W. Tracy Hankins, MD
Las Vegas Plastic Surgeon
4.9 out of 5 stars 293 reviews

Over or under the muscle?

Thank you for the question.  If you have breast ptosis,  you should not "elect" to forgo breast lifting surgery.  You will be better off avoiding breast surgery altogether.  In other words,  if you have breast ptosis, it is very unlikely that you will be pleased with the outcome of breast augmentation surgery done alone. Be careful with your decision-making… You may find the attached link, dedicated to larger breast augmentation surgery outcomes helpful to you as you learn more. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Not quite right

Hi there and thanks for posting. *warning you may not like this answer ( bit I suspect based on how you have put your question you expect this response)
Obviously without pics of your breasts it is not possible to absolutely guarantee that I am correct BUT I think it is highly unlikely that 800 cc implants either with or without a lift will give you a "naturally breast shape. Of course what is natural to you and what I consider natural may not be the same.  From my perspective a natural breast has a slope to the upper pole (compared to roundness), the most projected part of the breast is either at the level of the nipple or just below and the breast is in proportion to your body. On those criteria the operation proposed will not achieve a natural breast. 
Looking at pic one you appear to at least have grade one and possibly grade two ptosis. You would be at high risk for either a "snoopy dog" appearance or a double bubble with the proposed surgery. 
So you have one of two options. Compromise on breast shape or accept slightly smaller breasts and breast lift scars. 
Sorry but I just don't think the operation and implants you have chosen will give you the outcome you described 

Richard Bloom, MBBS (Hons), FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 117 reviews

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.