I am considering a breast lift with round implants - would over or under the muscle deliver my desired results? (photos)

Question

I consulted 2 surgeons that recommended over the muscle implants since i have enough breast tissue and an apparently big chest muscle My goals are to have a perky, round and enhanced look that ages well and is less likely to sag again. I like the fake look, but not too fake to the point where you can see the top edge of the implant which ive seen with some overs. If i went under, would it compromise the round, enhanced, cleavage look i like? I dont workout chest and dont plan to.

Farbod Esmailian, MD · Answer

Generally, most surgeon do not place implants strictly subglandular (in front of the muscle) any more.  There are too many issues that arise from this, so a better technique is to perform a dual plane (there are different Types) augmentation where the implant is partially behind the muscle.  
Also from your photos it does appear that you would benefit from a lift.  During the lift, some of the breast tissue can be removed and replaced with the implant to help achieve a more rounded look.  I would recommend looking at before and after photos that include a lift rather than just a straight augmentation.  I dont think, at least from the photos, that you can get away with an aesthetically pleasing result without a lift.

Hope that helps.

Randal Haworth, MD, FACS · Answer

You should be able to achieve that look utilizing a high profile implant subpectorally( «  under the muscle »). Doing so with a biplanar technique should  allow the implant to realise it’s full potential to fluff out the breast and rotate the nipple upwards. Essentially the biplanar method will provide the best of both worlds of being under the muscle while giving  you some of the feel of being above it. 
Of course i advise to get a few consults with board certified plastic surgeons before proceeding. Good luck !

Cem Berkay Sinaci, MD · Answer

Hello, I agree with my colleagues, you have enough breast tissue for a nice defined look with the implants. Your breasts look appropriate for a breast lift with over-muscle implants. You have a nice volume of breasts and If your implants will be places under the muscle, a waterfall deformity risk may be higher in comparison.

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

Martin Jugenburg, MD · Answer

Hello, thank you for your question. If you are thinking perkier breasts and less likely to sag again then placing an implant below the muscle will certainly be the better option. The implant below the muscle helps support the implant and is reduces the risk of capsular contracture compared to above the muscle. If you are planning on doing that, you may need to lift up your natural breast tissue. Speak to your plastic surgeon about your options. Check out our website for some really awesome before and after photos.

Connie Hiers, MD, FACS · Answer

Going behind the muscle gives better coverage so the edge is not seen nor do you look like two balls are stuck on your chest. Behind the muscle placement also gives some support to the weight of the implant to decrease the risk of sagging of the implant.  However, it is more painful and takes longer to settle.

I am considering a breast lift with round implants - would over or under the muscle deliver my desired results? (photos)

Answers (6)

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