Which would you recommend; over or under muscle. What is a more natural look? (photos)
Doctor Answers 12
Under or over the muscle breast augmentation
Under or over the muscle breast augmentation
Thanks for submitting your picture, though, bra less front and side view pictures would have been very helpful. I have been in plastic surgery practice for 28 years and performed breasts augmentation on thousands patients. My exclusive technique is placing the implants under the muscle for the following reasons: 1. Less nipple sensation loss, since the nerves cross on top of the muscle. 2. Statistically, less capsule contracture. 3. Better coverage of the implants , resulting in less palpable implants and less ripples, especially in a thin person like you. As far as size selection, you did not provide your chest circumference measurement ,which is critical for the correct size selection. Let's assume that your are 34 small B , 500 cc implants will bring you to 34 small DD. Is that what you had in mind ? In my opinion, it is excessively big. 34 full C or small D cup would be a better choice and the implant size for that would be, roughly, 350 cc. In regard to implant type, I use almost exclusively , smooth, round, moderate profile saline implants for the following reasons : 1. Cost $1000 less . 2. Allow for small incision under the areola , which is scar friendly as oppose to silicone implants that require most of the time long incision in the IMF (infra mammary fold ) which is scar unfriendly. 3. The incision under the areola allows for the creation of nicer cleavage and fold, due to ability to do that under direct vision and precise digital dissection. The sub mammary incision is too far for that. 4. When the implants leak or rapture, the saline implants replacement is very simple ( can be done under local anesthesia ) , where as the silicone implants replacement is complex. 5. Capsule contracture is more prevalent with silicone implants than saline implants. Finally, it is wiser to choose the surgeon rather than the tool or type of implants. Always, select experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive. Pay special attention to the cleavage area, the perkiness, the symmetry and the natural look.
Best of luck,
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Which would you recommend; over or under muscle. What is a more natural look
Greg Sexton, M.D.
Which is more natural-looking?
All the best,
Look is not predictable!
I prefer submuscular (dual plane)...
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) they can be seen with breast implants placed in the sub muscular position. I hope this, and the attached link, helps.
Which would you recommend; over or under muscle. What is a more natural look?
500 cc breast implants are huge and in my opinion will look unnatural on a patient of your build and size. Please see a board certified plastic surgeon who offers breast implant sizing using specially shaped implant sizers in a non-padded bra. For more information choosing breast implant size please read the following length:
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.