Over or Under the Muscle? So Confused! (photo)

Question

I have had four consults and the first 3 drs all said under the muscle. The 4th said over....I know his over work is good as I have seen myself by a friend that referred me to him (she was similar size). I am currently a 32A and ideally a the outcome would be a large C. I have no children. 5'4. 123lbs. I only want silicone and dr #4 said that over would give me the most natural look (I do not want huge torpedo breasts) and that I have plenty of breast tissue. Any input is appreciated! Thx

Reps B. Sundin, MD · Answer

I would also recommend submuscular placement for the same reasons as most plastics surgeons on here.   The implant coverage is superior and the complication rate lower.  There is a rare person for whom recommend subglandular implants.  I would recommend getting additional opinions if you are still confused and ask the surgeon about your concern.  Ultimately, finding a surgeon is a personal decision and you need to find someone you trust and develop a relationship with .  Ultimately, not sound patronizing, it is best to let your doctor guide you into making the right decision, just as you would with any professional.

Janet Woodyard, MD · Answer

In my opinion, implants should be placed under the muscle with only rare exceptions. The exception might be a severe tubular breast deformity. you can certainly obtain a very natural result with a sub muscular augmentation and mammography will be more effective with the implant under the muscle.

Adam Tattelbaum, MD · Answer

Thank you for your question. In my own practice I favor under the muscle implants. It has been my experience that under the muscle looks more natural and tends to hide the implants better specifically in a slender patient such as yourself. There is clear evidence that implants under the muscle have lower rates of capsular contracture and infection. Under the muscle will also provide you with a better mammogram when the time is appropriate. Lastly, should you need a lift or tightening in your future after childbearing, under the muscle preserves the blood supply to the breast better and makes lifting safer when necessary. Best wishes.

Ronald Schuster, MD · Answer

For women with the size breast and body shape like in the photo I would generally recommend under the muscle. It will reduce the incidence of capsule contracture over the long term (10-20 years from now) and will help to give you a "softer" look and reduce the chance of being able to see ripples or wrinkles. This is especially  true the larger the implant you want. But good results could certainly be had with a subglandular implant. There is not any right or wrong.

Edwin C. Pound, III, MD · Answer

There are pros and cons to both positions and each doctor has his/her own preference with regards to where they like to place breast implants.  If done properly, either position should give you a natural look.  I started my career putting all of my implants above the chest muscle because my dad did that for forty years.  He said that that was where the breast tissue was and that was where it would look and behave more like real breast tissue.  That was true.  The downside of placing implants above the chest muscle is that 1. there is a higher risk of forming capsular contractures, a thickened scar tissue capsule that can form around the implants causing the breast to become firm or distorted.  One theory is that capsular contractures form in response to bacteria and bacteria live in breast tissue.  By placing implants below the chest muscle, the muscle forms a barrier between the implant and the breast tissue where the bacteria may live.  2. If you use saline implants above the chest muscle, there is a greater chance of feeling/seeing ripples/wrinkles in the implants.  Again, placing implants below the chest muscle gives another layer of coverage over the implants and lessens this risk.  Despite the fact that it may take longer for the chest muscle to stretch and soften, I have changed my philosophy.  I now put almost all of my implants below the chest muscle (don't tell my dad!).  It takes longer to reach your end point but I think it is worth the extra time.  Based on your picture, I would probably suggest putting your implants below your chest muscle too.

Over or Under the Muscle? So Confused! (photo)

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Answer: Over vs. Under the muscle

Answer: Over vs. Under the muscle

Answer: Over or under the muscle so confused

Answer: Over or under the muscle so confused

Answer: Under the Muscle.

Answer: Under the Muscle.

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Answer: Under or over the muscle?

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Over or Under the Muscle? So Confused! (photo)

Answers (16)

Answer: Over vs. Under the muscle

Answer: Over vs. Under the muscle

Answer: Over or under the muscle so confused

Answer: Over or under the muscle so confused

Answer: Under the Muscle.

Answer: Under the Muscle.

Recommended reading

Everything you need to know about Breast Augmentation

Answer: Under or over the muscle?

Answer: Under or over the muscle?

Answer: Over or under the chest muscle

Answer: Over or under the chest muscle

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Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.