Would I benefit more from over muscle or under muscle? (Photo)

Dear Peaceful440372,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Based on your images, you have more than enough breast tissue to avoid a sub-muscular plane for your breast implants. Sub-muscular implants increase post-operative discomfort due to the dissection of muscle, and they also carry a risk of animation deformity. The advantage of submuscular for you would be a reduced risk of capsular contracture, but you can also achieve this by placing implants under the fascia of the muscle rather than under the muscle.
An experienced plastic surgeon will work with you to select the technique best suited to you.

There is overwhelming high level evidence that a submuscular position (dual plane pocket) has the least amount of potential future problems in breast augmentation. I would recommend finding a board-eligible or board-certified plastic surgeon with aesthetic surgery fellowship training (a total of 7 years of plastic surgery training). In addition, it helps to have a 3D simulation to see what the potential results are.

Most of the breast augmentations I perform are under the muscle. The benefits include a more natural look, a lower occurrence of capsular contracture, and it disguises the upper portion of the implant. Based on your stated goals it seems submuscular would work well for you.

I prefer placing the implants behind the muscle for better upper breast fullness, hiding the implant edge, and some support to the weight of the implant. Measurements are needed to see if a lift if needed. Two photos do not show sagging, but two photos do.