Are 500cc To Much For Over The Muscle?

There are many reasons to have your breast implants placed subpectoral (under the pectoral muscle). It's easier to interpret mammograms, lower incidence of capsular contracture (scar tissue) and a more natural contour to the upper portion of the breast. Those larger sized implants (450 and 500) are quite heavy and may lead your breasts to sag more quickly as you get into your mid-thirties; especially if they are in a subglandular (in front of the muscle) location.

I would also consider an incision placed in the fold of the breast (inframammary) as this is associated with a lower rate of capsular contracture and does not violate the breast tissue as much as the periareolar approach.

For sizing, I prefer to use 3D imaging which simulates what you may look like with various sized implants. This takes alot of the guesswork out of which implant is best for your particular frame.

You may want to visit with one or more board certified plastic surgeons if this is still not 100% clear to you.

Best wishes,

Dr.Bruno

With your height and weight, I feel that a 500 cc implant is too large. Although if placed correctly under the muscle, you could still get a nice result. If  the implant is placed above the muscle, I feel that it  will not only be too large but will cause future problems resulting in stretching of the skin and sagging.

Hello Curiouslatina,

Going under the muscle will give you the best chance of minimizing complications like capsular contracture and rippling in the upper part of the breast.  There is not much of a difference in appearance between a 450 and 500 cc implant, but they are certainly near the appropriate limits of your anatomy, based on your reported BWD of 13 cm.  In an ideal world, 400 cc might be a safer choice, I would need to examine you directly before making a recommendation.  Periareolar incisions are associated with the highest rate of capsular contracture, and I would recommend an endoscopically assisted surgery through an armpit incision by a surgeon that specializes in that approach.

Best of luck!

If possible, I would always recommend under the muscle.  In general, a 500 cc implant under will equal the size of a 450 cc over the muscle.   In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Over or under really depends upon your anatomy. In most cases I prefer under because most of the women I see do not have a lot of soft tissue coverage.  Hard to say without an exam.