Can I achieve defined cleavage with over the muscle implants? (photos)

Question

Im getting a breast lift with implants and expecting to have my implants placed over the muscle as per doctors recommendations. One thing im wondering about is whether over the muscle implants can achieve the crisp border, defined look that i like. Ive attached photos of my wish photos. Not that i know results may be different with a breast lift + implants, im just trying to get as close as possible to my wish photos though.

Randal Haworth, MD, FACS · Answer

Breast implants placed over the muscle can provide a more defined and rounded look to the breast, particularly if you have a low body fat percentage. This type of implant placement can create a more dramatic cleavage and upper pole fullness, which may be closer to the look you are hoping to achieve.

That being said, the outcome of your breast augmentation will depend on various factors, such as the implant size, shape, and profile, your body type, skin elasticity, and the surgical technique used by your surgeon. It's essential to have an open and honest discussion with your surgeon about your goals and expectations for the surgery.

Your surgeon may also recommend combining the breast lift with implants to achieve the best possible results. A breast lift can address sagging or drooping breasts by lifting and reshaping the breast tissue, while implants can add volume and improve the overall appearance of the breasts.

Ultimately, the best way to determine if over-the-muscle implants can achieve the look you desire is to consult with a board-certified plastic surgeon. They can assess your individual needs and provide personalized recommendations based on their expertise and experience.

Daniel Barrett, MD · Answer

Dear Courageous273678,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Providing that your surgeon selects wider base implants (moderate, moderate plus), it is possible to enchance your carrent cleavage, in particular with subglandular implant placement. Addition of fat grafts in that area can furher contour the cleavage and upper pole of the breasts. That can be done in the same time or one can waith 6-12 months for result of breast lift/BA to mature and perform additional adjusements with fat grafting as needed. Good luck.

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Usually above the muscle you can create a bit more cleavage but of course Plastic surgeons are limited by the midline and avoid at all cost symmastia. Speak to you plastic surgeon about your wish pic to get better expectations of your own outcome.

Gary M. Horndeski, MD · Answer

Implants over the muscle devascularize the breasts to a certain degree. Also, a breast lift will devascularize in addition. A combination of the two may results in complications. You would be better off with a breast lift and implants behind the muscle. Certainly, implants in front of the muscle provide more definition but there is an alternative technique that I recommend called a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

John LoMonaco, MD, FACS · Answer

Cleavage depends on several factors, including the natural location of your breasts on your chest wall, the natural width of your breasts, how wide your breastbone is, and where the muscle attaches to the breastbone.

Surgeons have some control over the pocket they create but it is unwise to separate the muscle from the breastbone too much or over-develop the pocket. Surgeons can also use implants that are a bit wider then your natural breast to aid in getting cleavage.

Every patient is different, so look for a surgeon that discusses all these factors with you

Connie Hiers, MD, FACS · Answer

I am not a fan of the round ball look with breast implants. However, some women like that look and it is achieved with implants placed on top of the muscle so that their edges can be seen as in your third photo. Going behind the muscle gives a more natural look and also helps support the weight of the implant for less risk of future sagging.

Douglas Taranow, DO, FACOS · Answer

The subglandular breast augmentation along with a breast lift will give you the cleavage and roundness you desire. 
One possible issue is the potential for Medial (cleavage) rippling.

Can I achieve defined cleavage with over the muscle implants? (photos)

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