Im Getting 616cc Silicone Gel Implants. Moderate Profile, and Under The Arm Pit Insertion?

Im getting 616cc silicone gel implants. Moderate profile, and the Dr is putting the implant in via under my arm pit. Over the muscle, will I get the big busty look I desire? Top Heavy some call it? I wear a 5/6, My height is 5'4 n 1/2.. I have Pre Op 32-36c. I told the Dr's assistant I wanted never to wear again push up bra's wanted to have that big boob"d look...My Dr, he hates answering questions...

Doctor Answers 10

616cc above the muscle?

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I agree, seek another opinion, your PS should be open to questions. I think that 616cc above the muscle will put lots of strain on your breast tissue and the youthful look that you desire will be short-lived. Good luck!

Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Maximum lift with minimal implant

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The goal of breast surgery is to create beautiful breasts.  You want larger size breasts and don't want to wear a push-up bra.  It is possible you may benefit from minimal size implant with a maximum lift procedure instead of a huge 616 cc implant.  I would definitely not put 616 cc silicone gel implants in front of the muscle.  The weight of the implants ( 1 1/2 lbs each) will descend over time and you will not have the upper fullness you desire.  You will require future surgery revisions and sooner because of the large size.  Also, it can be technically difficult to place a 616 cc silicone gel implant through the arm pit.  You need to seek another opinion.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

A few things dont add up

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Thank you for your question.  You and your plastic surgeon are the best at deciding on the plan of the procedure however, playing devils advocate I would like to raise a few points for your potential benefit.  First and foremost your doctor should be answering all of your questions.  That is his/her responsibility to you.  The second is the surgical plan.  Moderate profile on top of he muscle and very full upper pole seem to be less than ideal in my humble opinion.  I would imagine that a moderate plus or HP implant would be better for this.  Lastly, for your height and implant size I am wondering why an incision under the breast fold is not considered.  You can get a large implant through an axillary incision but a 600+ wide implant (moderate) seems a bit big to go through the axilla even using a keller funnel.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

616cc implants over muscle

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I would advise against this. Soon I expect you will lose the upper fullness and over time you are likely going to have the "rock in a sock" appearance. This is a complicated problem to correct!

Andrew Stewart, MD
Charleston Plastic Surgeon

Advice on a patient's choice of implant and approach

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I can understand why the doctor hates answering questions if he is planning to do whatever the patient thinks they want and can have including enormous gel implants placed above the muscle and through the armpit. 

Experience over many years supports the best approach to breast augmentation for both short and long term results is to put the implant under the pectoralis muscle for the upper part of the breast, use the inframammary crease approach, and use an implant that fits the width of the breast rather than just choosing an implant volume number. Too large an implant and above the muscle is a set-up for needing a revision later which will end up with a new inframammary crease incision even if the original incision was axillary. 

I would advise a high profile implant that matches the width of your breast and place it under the pectoralis muscle through an inframammary crease incision. Later on if you want to go larger, a replacement can be done through the inframammary crease and your tissues will accommodate a larger implant in both width and forward projection. 


Scott L. Replogle, MD
Boulder Plastic Surgeon

WIll large implants lilft my breasts?

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Dear Christina.  Without photos of you and your desired look, it's difficult to fully answer your questions.  After 18 years of practice, I've noticed that women that select large implants tend to have many more problems and revision surgeries years later.  The tipping point is around 350 to 400cc.  So, at over 600cc, I think you're committing yourself to multiple expensive surgeries in the future.  As far as going through the underarm, I would ask your surgeon if he uses an endoscope or just "blind" dissection with a blunt instrument.  The endoscope allows for more precise placement, less bleeding, and lower complication rates.  Also, putting in a 616cc silicone implant through the underarm will require a large incision.  Even if your doctor uses a Keller Funnel (which is also recommended), it still may be a large scar.  Please don't rush into this surgery.  If your doctor doesn't want to talk to you, don't settle for his assistant.  If he's difficult now, imagine how much worse it will be if you have a problem and aren't happy with the results.

Im Getting 616cc Silicone Gel Implants. Moderate Profile

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We get frequent questions like this on Real Self and in our practice. It seems a common misconception that big implants will give lots of high volume. Heavy implants do NOT move up, they move down like any other kind of weight. The only thing that could keep them up is thick and strong skin and breast tissue. Most ladies getting big implants aren't starting out with thick breast tissue. And BTW, the doctor's job is to answer all your questions. If he is not willing to perform his job, I would not personally be willing to have him do the job.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast Augmentation

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I would seek another opinion.  You need to find a PS you can speak to - one that will answer your questions.  In addition to that an implant of that size placed over the muscle will cause additional sagging in years to come forcing you to wear a support bra continuously. I think the armpit incision is fine as long as your PS is familiar with that approach.

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast Augmentation

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I would ask to speak to the surgeon.  It would be very difficult to insert that size gel implants through the armpit.  I would also ask him about the longevity of placing that size implant over the muscle and if it would cause sagging in a few years.  It is best to communicate your operative concerns to the surgeon and if he is unable/unwilling to address them, then seek another opinion.

Good luck


Leonard Harris, MD
Burlington Plastic Surgeon

Achieving Goals with Breast Augmentation?

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Thank you for the question.

Although I cannot give you precise advice about the specific breast implant size/profile that will most likely achieve your goals, I can tell you that careful/clear communication with your plastic surgeon will be a critical  step in achieving your goals.  I would suggest that you request an additional consultation with your plastic surgeon  to clarify your goals and have your  questions answered.

Best wishes.

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.