Over the muscle or not? (Photo)

Which is better? Or does it matter. Id like a lift with silicone implants

Doctor Answers 6

Over or under the muscle

can be done as each technique have their own supporters.  With the dual plane method, there really isn't any reason why you have to go over the muscle except for the desire not to have any distortion with muscle contraction.  Everything else is worse over the muscle with more rippling, worse mammograms, more potential for 'rock in the sock', and less fullness on top with time.  Only thing bad about under the muscle is the movement and inability to completely remove the capsule if it ever became necessary.  BTW, I'm a under the muscle advocate.  Oh, and from the lock of your photo, you will need a lift as well.


Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Over the muscle or not?

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue… Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures. At the first 3 to 5 months, it is too soon to determine how your results are going to be, per now, they look very nice and beautiful, you can have one bigger than the other, feel swollen and also have bruises and open wounds, it is normal and that can happen for the first 3 to 4 months until your implants have settle in. I recommend you to wait and keep using your post surgical bra, that will help you with the shape and support…

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 359 reviews

Over the muscle or not?

Thank you for your question.Most women do best when implants are placed under the muscle. The muscle provides another layer of camouflage for the implant. It decreases the chances of visible rippling and a palpable implant edge.Seeing a board-certified plastic surgeon is the best way to decide how to proceed. They will talk with you about all of your options.

Breast Lift / Breast Augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/ Silicone Implants

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 Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon #RealSelfCORESurgeon

Over or Under Muscle

Thank you for your question. For the majority of patients, under the muscle is the best option. It provides the best coverage for the implant and the least chance for capsular contracture (scarring around implant). Be sure to consult with a board certified plastic surgeon to determine what option is best for your situation. Best, Dr. Kludt

Nathan Kludt, MD
Stockton Plastic Surgeon
4.8 out of 5 stars 26 reviews

Over the muscle or not?

There are two main reasons for going under the muscle: first, to get better coverage to camouflage the upper edge and hide potentially visible upper pole implant wrinkling, and second, to reduce the risk of capsular contracture. Other benefits may include the implants holding their position better over time and better quality mammograms. Although your photo is not a good one to judge by (that is, lying down in a bathtub rather than standing), your areolas appear to be very large and low...it would be difficult to perform a good breast lift at the time of implant placement as the tension on the wound closure would be extreme and could lead to significant complications. I would suggest a breast lift, to be follow in a few months by implant augmentation.

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.