Should I get my teardrop implants under or over when I am very slim with no natural breast tissue?

I am very slim, around 118lbs (8st 2lbs) & I'm just under 5f 8". I have hardly any natural breast tissue, I used to be a 32AA cup until I had my first BA. I only have 220cc's at the moment & they're unders but if I flex my right pec I get a deformity in the implant. My Q is, should I go under again? My PS says that's the 'only' way to prevent it happening but I am worried in case the implants (425cc teardrops) will be too obvious as overs as I don't have any natural breast tissue. What do I do?!

Doctor Answers 4

Breast Implant Placement

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Thank you for your question. A personal exam and consultation is always best.

That said only a physical examination can determine, based on your deformity issue and the fact that you have already an established pocket, the best placement and type of implant that is best for you. Not every patient is a candidate for tear drop implants.

Below please read the link explaining breast augmentation revisions.

Be sure to consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in your procedure, and who has an excellent reputation in your community.

Under or over

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I would suggest keeping them under the muscle for several reasons: 1. You already have a pocket there. Why make a new one somewhere else? Maybe your doctor needs to tweak the right pocket to minimize the risk of deformity when you flex your right pec but that is a minor adjustment. 2. Despite the fact that silicone gel feels more natural than saline, it is still not real breast tissue and has the potential to look/feel artificial, especially if you turn or twist in certain ways. The deeper you can bury it, that is, the more tissue covering the impalnts, the less likely this is to happen. 3. There are risks associated with putting implants on top of the muscle as well. The predominant theory about capsular contractures is that they form in response to bacteria. Breast tissue has bacteria living within it which may help explain why the risk of forming capsular contractures is greater when implants are placed above the muscle. By placing them below the muscle, the chest muscle forms a barrier between the implants and the breast tissue where the bacteria live.

There are pros and cons to placing implants above or below the chest muscle but I think most plastic surgeons these days prefer the under the muscle location.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Breast Augment

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There is a trend brewing of putting more implants above the muscle to reduce complications like the one you have. I think your main issue would be traction rippling with this type of implant. All implants have trade offs and the most important thing is to decide with what you can live with as there is no perfect surgery

Breast Augmentation

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I would only place such an implant under the muscle. I can't comment on your specific situation as you haven't posted any photos.

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 reviews

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.