Should I go over or under the muscle? (Photo)

Hello,
After seeing your photos and your wish photos I may suggest to go on top of the muscle, under the subfascia lining.
All the best,
Dr. Joe

Hello, thanks for asking, if you are looking for results similar to those photos, you should get a large implant, and it should be above the muscle.

Most implants are placed behind the push-up muscle to help create a natural contour to the upper part of the implant. Because I am very focused on how the implant fits your life, I don’t think that all patients should necessarily have an implant behind the muscle. If you enjoy heavy lifting with your chest (bench press, burpees, inverted yoga positions, etc.) and you do not want to see your implants move, then placing the implant in the front of the muscle may be ideal for you.

You won't get consensus even among surgeons on whether over or under the muscle is better. My preference is always under the muscle as it has less chance of capsular contracture, and less chance of rippling and implant visibility. But best to find a plastic surgeon you like and trust and go with their recommendations. All the best

There are advantages and disadvantages to both subglandular and submuscular placement. I typically recommend submuscular implant placement for patients who don't have a lot of their own breast tissue to "hide" the implant (this isn't you). I typically recommend subglandular placement for patients who who use their chest muscles for strenuous activity like CrossFit because forceful contraction of the muscle over time can displace the implant. When there isn't a clear reason to choose one location of the other I tend to recommend sub muscular placement because it tends to look more natural and there is a lower rate of capsular contracture over time.

Thank you for your question and photos. The wish list of photos you sent show large implants and a "fake" appearance of breasts, not a natural look. If that is the results you desire, then I would recommend a large, silicone implant placed on top of the suscle.

Thanks for your question! For as large as you are trying to go, I may suggest a subglandular augmentation. I agree with you that this will take some time and a few surgeries. Good luck!

Based on photos you provided, placing the implants above the muscle would probably be the method of choice.

Looking at your photos, I would usually recommend going under the muscle, because you seem to have little upper pole breast tissue… But I think the best way to achieve any of the results of your wish pics would be to place the implants over the muscle.

Dear Bright813121,
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