Mammograms easier with over or under muscle saline implants?

Having 2nd BA in 2 weeks. Switching out from 339cc under silicone implants to approximately 550 cc saline. Are mammograms easier to read with implant under or over muscle. Confused. Also I want volume to be most it can be. Will going over muscle give me the biggest look?

Doctor Answers 4

Mammograms easier with over or under muscle saline implants?

Generally, the evaluation from a mammogram is easier when the implant is under the muscle.  Placing the implant above the muscle will give a more unnatural look.  Volume doesn't change.


Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Over or under muscle and mammograms

Most feel mammograms are easier to interpret with the implant under the muscle.  In either case, additional views are routinely obtained to ensure adequate visualization of the breast.  The volume does not change from one position to the other.

David A. Lickstein, MD
Palm Beach Gardens Plastic Surgeon
5.0 out of 5 stars 5 reviews

Mammograms easier with over or under muscle saline implants?

Mammograms can be done in either case but are better when the implants are under the muscle. The volume appearance will be the same. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 reviews

Mammograms easier with over or under muscle saline implants?

Thank you for the question. I think that there are many good reasons to utilize the sub muscular space for breast augmentation surgery as much as possible; decreased interference with mammography is one of those reasons.  Based on the studies that I am aware of, there is decreased interference with visualization of breast tissue of breast implants placed in the sub muscular position as opposed to the sub glandular position.  You will find much more information regarding the pros/cons of breast implant positioning options on this website.
 In regards to your question regarding breast implant size: ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.   Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "D or DD cup” or "biggest look" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice. 3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 


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.