Saline rupture - can I go over the muscle with silicone 500cc & look natural?

Question

Have very little breast tissue, will exchanging implants from under to over the muscle make the implant noticeable? Over 20+ years ago I had saline implant surgery, since then (March 2022) they've ruptured. I'm looking to replace them with silicon. My first set were placed under the muscle. The new Im considering placing above, however, with having very little breast tissue I'm affaid the implant will be noticable With the cohesivness of the implants now should that be a concern? Im also looking to go larger 500cc +

Gary M. Horndeski, MD · Answer

Your biggest problem is your excess hanging skin.  You will need a lift and the technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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.  Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Richard Baxter, MD · Answer

Although the more cohesive implants can look natural in front of the muscle, it is less likely with larger implants and little breast tissue. It would be helpful to know what size your implants were before deflation and whether you liked that size.

Gerald Minniti, MD, FACS · Answer

There is absolutely no good reason to make a new implant pocket over the muscle. You don't state your reason, but if you think it will allow you to avoid a very much needed breast lift, you are very wrong. If you don't get a breast lift your breasts will look terrible regardless of where the implant is sitting.

Ronald J. Edelson, MD · Answer

I see no reason to go over the muscle. You don’t say why you want over the muscle. There’s nothing to be gained

Daniel Barrett, MD · Answer

Dear SunShine Baker,
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

Saline rupture - can I go over the muscle with silicone 500cc & look natural?

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Saline rupture - can I go over the muscle with silicone 500cc & look natural?

Answers (7)

Answer: Breast implants

Answer: Breast implants

Answer: Implant placement

Answer: Implant placement

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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.