Are 350cc Implants Too Large For Over The Muscle Placement For Me?

Dear claire-

 

Regarding your details and the implants suggested to you, you may want to consider trying a different profile breast implant.  You noted that you were given a choice of 290 cc low profile implants, but you may need to mid range, moderate, or high profile breast implants to give you the volume and shape that you want.

You stated that you have some loose skin to fill, which also implies that you could probably more easily accomodate a larger implant.

Your breast and rib cage measurements help to confirm you have a smaller frame, but you will want to see a plastic surgeon in person for the final decision regarding breast implant profile and volume size.  Generally, the breast implants are fitted to your breast width, along with other measurements. 

Although you mentioned in your title question about "over the muscle" placement, you never really talked about it in the rest of your question.  If you have little breast tissue, a smaller frame, and you want to go from 32AA to 32 large C, you may be best suited for under the muscle placement of your breast implants.  This is a little more painful, but has a better "feel" with less chance for rippling or wrinkling, compared to above the muscle placement.

 

Best Wishes to You!

Roy

 

 

It is difficult to determine without photos. Clear communication with your plastic surgeon is important in achieving the desired goals of the patient.  I like to communicate with patients with “goal” pictures.  During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal.  I think it is too much responsibility for the patient to choose the size of the implant.  Ideally, the surgeon would make that determination once he/she is in the operating room with sizers in and examining the patient in the upright and supine position.  There are many variables that come into play when choosing the correct implant size (how much breast tissue the patient currently has, the shape of the chest wall (concave vs. convex), etc..  It is difficult to determine exact cup size pre-operatively and post-opertatively. Every manufacturer produces a variety of bra styles, which may differ in size and shape.

On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.

Actually, you need to choose your implant size in a more precise manner than just being handed a certain size.

To accomplish this In our practice, we use the appropriate sized bra, and then the patient tries on each size implant, using a gel implant sizer, until she feels she has exactly the right size for her, not too large, not too small.  Too many times have I seen unhappy patients whose implants are not the "right" size, because the doctor made the choice for them.

The usual implant is the moderate profile in my practice. They look feminine and have nice projection and shape.  Low profile implants are so flat and wide for the volume, they don't do the job that women want. They are certainly not perky.  High profile implants are reserved for women who want more volume but whose breasts are not wide enough for moderate profile, or who just like the look of high profile

Putting the implants partially under the muscle is the only way to provide some soft-tissue coverage in the upper breast for a woman who does not have at least 2.5 cm of pinch thickness in the upper breast. If you don't, and it sounds like you don't, then you have increased risk of issues like implant visibility and visible wrinkling to deal with, if not right away, then down the line when the skin stretches, not to mention the increases risk of capsular contracture when above the muscle.