For saggy boobs, should I go for over or under the muscle implants?

This is a common question. There a pros and cons with each. If you are trying to avoid have a lift and your natural breast tissue sits low than some women consider placing the implants above the muscle. However keep in mind that with time the implants will drop. If you are getting larger implants they tend to be heavier and if you have only breast tissue supporting an implant vs the muscle supporting the implant, this tends to drop with time and gravity a lot faster. Other cons about going above the muscle is there is a higher chance of capsular contracture. Cons about below the muscle is animation deformity and you would need a breast lift so that the breast tissue can be at the level of the implants.

If your breasts are saggy then implants will solve your problem. You will need a lift. Many women do not like lifts because of the vertical scars associated with the traditional techniques. For that reason, an alternative was developed called 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Most of the implants I place are beneath the muscle. This provides a more natural look, lower capsular contracture rates, and the muscle "disguises" a portion of the implant. Implant placement beneath nor above the muscle will take the place of a lift. If a lift is needed it can often be performed along with the augmentation.

Hello and thank you for your question.
It is difficult to answer the question without seeing photos, but sometimes, if the breasts are very droopy, a breast lift procedure may be needed in addition to placing the breast implants.
A mastopexy (breast lift) will put your nipples into the correct position, decrease the size of nipple/areola and allow excess skin to be taken away, giving you a more youthful looking breast. Some people are a little apprehensive to the full breast lift due to the scars, but typically they do very well.
Breast implants add the upper pole fullness and cleavage that many patients desire.
I would recommend to obtain an in person consultation with a Board-Certified Plastic Surgeon to further discuss your options and expectations.
I hope this helps.
Best, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Thank you for sharing your question. Unfortunately without an in-person examination or full series of photographs it is difficult to offer advice. In most cases of breast sagging, the best treatment is to pursue a lift with an implant augmentation.