Lift with 450cc - Over or under the muscle? (photo)

Thanks for your question and the photo. Without an exam and measurements it is hard to say exactly what I'd recommend. Combining a lift and an implant is a tricky operation and has a high revision rate and can end up being very expensive. Most surgeons would not use a HP implant with a lift. Placing an implant that is that large (450CC) definitely will put a lot of stress on your lift. I would not place the implant above the muscle. You will have higher incidence of contracture and risk of nipple devascularization above the muscle. Best of Luck!

Hello and thank you for your question. There are several advantages
and disadvantages to over vs under the muscle.  Under the muscle has the
advantage of lower capsular contracture rates, less risk of rippling, and
better visualization with future mammograms.  Most patients say that under
the muscle also has a more natural look and feel.  The size, shape,
and profile of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality. 
This decision should be based on a detailed discussion with
equal input from both you and your surgeon.   Make sure you specifically look at before
and after pictures of real patients who have had this surgery performed by your
surgeon and evaluate their results.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon