Under or over the muscle? If I go over, should I go smaller? (Photo)

Question

Hi, I'm 28, no children, healthy lifestyle, no major health issues (except IBS), 34B. My dr and i decided 330 cc moderate profile silicone. I'm stuck on whether I want to go under or over muscle. I'm considering over because I do aerial, pole dance, yoga and I'm concerned about animation for under. I'm worried abt CC for over (&if I have children breastfeeding). My dr said I can do either. Any opinions? If I go over should I go smaller? If I go under do I have to give up my hobbies forever?

Alan Gonzalez, MD, FACS · Answer

Hello @T Williamson thank you for your question and showing your pictures. You have another possibility that allows you to keep the form of the breast while and after breastfeeding when the time comes and to continue with your activities, after a time to heal properly. This position is behind the muscle fascia is a safe and suitable technique for young women that gives the breast a natural and beast aesthetic result in my opinion. For more information and recommendations is best to consult with one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a good candidate for breast augmentation. If you are worried about animation deformity based on your activities, you should consider going over the muscle. Neither location will significantly impact your functionality. I hope this helps.

Brian K. Reedy, MD · Answer

Thanks for your question! I'd say about 99% of my patients choose a submuscular approach and it does not affect their lifestyle. I encourage it because of decreased risk or capsular contracture and numbness to the nipple. Good luck!

Gary M. Horndeski, MD · Answer

The technique I recommend is 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, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear t Williamson,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Going under will give better upper breast fullness and better coverage and support for the implants. However, you will have animation deformity when you flex the muscle. For many women, this is not a problem.

Raul Trujillo, MD · Answer

Hello, thank you for your question. I think that you should continue with your hobbies, as they are part of your lifestyle, and over the muscle augmentation could give you that versatility in continue with such physical activities and not worrying about motion deformity. The volume is a great choice for you, as you have slim build.

Joshua B. Hyman, MD · Answer

It is always a better idea to go under the muscle. There is less capsular contracture and a more natural result. Going under the muscle not have any affect on your "hobbies" and will not limit you in anyway. I would be a little concerned that your surgeon left this decision up to you as they are the expert.

Under or over the muscle? If I go over, should I go smaller? (Photo)

Answers (8)

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