I'm 5,5 65 kg size 34b currently 29 years old going for a 325 cc implant .

I'm confused about under or over? My surgeon thinks I can get away with over as I don't want them to age but I want a natural looking finish. Does going under noticeably age more than going over ?

Doctor Answers 4

Over vs under.

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Hello, each surgeon will have their own criteria for inserting implants over or under the muscle.  In general my default position is under the muscle so the implants have better coverage, but in selected cases (such as a person with ample breast tissue and a slightly droopy nipple) I might suggest implants above the muscle to help correct the breast shape.

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

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I appreciate your question.

The best way to determine implant size is based on chest wall measurements that fit your body.  Once we determine that we can choose the profile based on what you want or need to achieve.  

Implants under the muscle, there is less risk of capsular contracture.  Anatomic implants tend to give a more natural shape with more nipple projection.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon



Under or over pec major for breast implant placement

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Thank you for the question. There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well. 

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.   

 Best wishes with your decision making and an outcome that you will be very pleased with.

Over or under?

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Greetings Helen! Thanks for this question. I usually must have a very good reason to recommend above the muscles such as an extremely physically active patient who uses the pectoral muscles a lot (ie. yoga instructor, body builder). I also look for a lot of breast volume to cover the breast implant and reduce ripples - so the breast pinch should be greater than 2.0 cm thickness. Above or below won't affect aging very much. Perhaps before deciding to move forward with surgery you should speak with a few more surgeons and carefully contemplate your options. You can also read a bit more about above and below in the link. 

Best, Dr. ALDO :)

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 211 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.