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.

I favor putting implants under the chest muscle because my radiology colleagues  think  this  position  interferes  less  with  mammography  and  the early  detection  of  breast  cancer  than  if  the  implant  is  placed  on  top  of the  muscle.  Not  all  surgeons  agree  on  this,  but  I  like to  err  on  the  side of  caution. The  alternative  is  to  place  the  implant  on  top  of  the  muscle but under the breast tissue. The chance of irregularities is much higher when the implant is placed on top of the muscle in a patient who has little overlying breast tissue to cover the edges of a saline implant (incidentally, this isn’t as big a problem with silicone.  All the best.!  "Dr. Joe"   

Yes it is feasible to achieve natural looking results but it is hard to say for sure based on photos alone.   As I stress with my patients, the choice of implant
size and type would best be done through an in-person examination. There
are a lot of factors that can affect your choice like the desired end result,
breast tissue, body measurements, and the like. It would
always be best to visit your board-certified plastic surgeon and get a full
evaluation for your concerns. Best of luck, Dr. Michael Omidi.

An
in-person exam with a board-certified plastic surgeon is the best way to assess
your needs and provide true medical advice.