Can a Small Implant Placed Above the Muscle Look Natural in a Thin Woman? (photo)

Your posted photo shows widely spaced breasts without cleavage, stretched out areolae,right breast crease higher than the left, right nipple higher and further from the midline than the left nipple and right breast smaller than left. Every approach has its pros and cons you will need to weigh those before deciding what to do. Under the muscle implants can distort with muscle movement if the muscle release is inadequate but the risk of visible rippling is less.

In your case it is as or more important to make surgical adjustments to the breast skin and tissue and place a larger implant on the right side. The right breast fold will likely need to be lowered and the nipple complex positions adjusted in order to achieve an optimal result. You do not have cleavage now and it is important to realize that breast implants cannot create that cleavage.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Your concerns are well warranted and there is a lot of conflicting information out there!  My first piece of advice is forget about subglandular, even if it looks great immediately it simply will not last long.  When it comes to dual-plane adding coverage, well this depends on your definition of coverage.  The pectoralis major ALWAYS has tone in it, therefore if used to define the superiorpole, it will ALWAYS INCREASE definition of the implant and create a sooped out unnatural look.  

 

The advantage of true subfascial augmentation is that supporting tissue can be draped over the superior pole of the implant creating a natural tear-drop effect even with a round implant.  I prefer what I call the 'cold-subfascial breast augmentation' because it protects all of the fascia to accomplish these goals.  Beware, there are many surgeons that advertise their 'subfascial' technique but completely destroy the fascia thus delivering a subglandular result.   Pay attention to before and after pictures and these will become obvious to you.  I hope this helps!

 

 

All the best,

 

Rian A. Maercks M.D.

Yes, a small implant 200cc - 250cc placed in the subfascial plane can look natural in a thin woman. A 280 cc implant is only 12% larger than a 250cc implant. If distortion on muscular contraction is a big issue for you, go subglandular/subfascial. Be advised, however, that submusclar can be easier for mammograms and has a lower rate of capsular contracture.