Is over the muscle breast augmentation with gel or saline better?

If you have drooping breasts you will want to consider a lift. Neither over the muscle nor under the muscle implants are able to give the same result as a lift. As far as selecting saline or silicone, there are benefits and drawbacks to each. I've included a video that summarizes this that I hope you find helpful.

If you are sagging, get a lift. Implants will not correct for sagging. Going over the muscle, chose gel implants to avoid seeing ripples.

Thank you for your question. A large portion of my practice is dedicated to breast revision surgery. The biggest mistake I see by surgeons and patients is getting implants placed on top of the muscle. Almost always, the implants drop with time and look horrible after just a few years. The idea that you can use an implant on top of the muscle and feel the skin envelope is flawed. By placing a large heavy object in skin that is already drooping and stretch results in even more stretching and a droopier breast. I have seen this way too frequently and wrote a paper entitled " Poor practice". If you need a lift, then you need a lift, it is just that simple. Best wishes to you.