Should I Have Gone Under the Muscle? Would It Fix my Problem? (photo)

I am 5'8, athletic, and wore a 36B but didn't fill an A cup (as you can see.) I got a BA 7 months ago and got 450cc silicone, over muscle. My goal was to look proportionate and natural. I am happy with the size but not satisfied with the look since I can see my implant outline, I have a huge gap and my cleavage isn't what I expected. Should I have went under the muscle? Or am I just built this way? Can it be fixed?

Doctor Answers 4

Should I Have Gone Under the Muscle?

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There are a number of reasons that some surgeons would have recommended under the muscle placement, though better cleavage is not one of them. Capsular contracture is less common, and often the appearance at rest is more natural.

When a patient's natural breasts are widely separated, cleavage is not going to be accomplished. If the breasts are wide, so is usually the insertion of the pectoral muscles into the breast bone, and this may result in still further separation of the implants.

Other than for the capsular contracture which is distorting the right side, I think your outcome is otherwise quite good. I would suggest discussing with your surgeon the non-operative approached to capsular contracture. If those fail, an operative approach should include consideration of moving the implants behind the muscle.  Best wishes

Seattle Plastic Surgeon

Breast augmentation, under or over muscle?

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Hello! Breast augmentation over the muscle tends to look more "natural," with more weight on overlying breast tissue. This is why your implants look this way. You can have the implants converted to under muscle. You may potentially be more aware of the implants under the muscle with athletics. I wouldn't necessarily recommend further surgery unless you are very unhappy. Good luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 57 reviews

Wide cleavage and visible implant outline

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Although to answer from photographs without examination is not correct. I feel widening implant pocket on medial side and replacing implant with less projection can solve your problem of wide cleft, visible implant line and capsular contracture

Milan Doshi, MS, MCh
India Plastic Surgeon
4.8 out of 5 stars 196 reviews

Should I Have Gone Under the Muscle?

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While many surgeons prefer placing the implants under the muscle in thin patients, it does not alter the spacing of your breast differently than subpectoral placement. It appears that you may have capsular contracture which is distorting the shape of the right breast. There are options to correct. I would recommend that you discuss with your surgeon. Dr. Griffin

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