Do over the muscle implants sag/hang faster? (photos)

Good afternoon,
Definitely go under the muscle- overs will sag and hang faster, mammograms aren't as good, and the capsular contracture rates are double. Under the muscle stays higher, perkier, for longer!

Thank you for your question.

The breast, which is mainly composed of skin, adipose tissue and mammary gland, is fixed to the rib cage by the resistance of the skin and suspensory ligaments. If suspensory ligaments are loose and skin tension is low, a breast may sag regardless of its size. Even breasts with small volume may sag due to loosening of the skin and suspensory ligaments due to births and breastfeeding. At the same time, even though it is large, a breast with strong skin structure and ligaments might not sag. As a result, the characteristics and structure of each breast differ from one another.

Dear Katarina94,
determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your breasts are too low on the chest wall for implants alone and you will need a lift. 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.

Thank you for sharing your question and photographs. Based on your supplied images I think you need to have lift performed regardless of the position of the implant with respect to your chest muscle. I would favor going under the muscle with a well-sized implant and a lift on top to minimize a double bubble deformity,

Thank you for your Question.
Enhance your appearance if you think your breasts are small or that one is smaller than the other and this impacts how you dress or the type of bra needed to help with the asymmetryAdjust for a reduction in the size of your breasts after pregnancy or significant weight lossCorrect uneven breasts after breast surgery for other conditionsImprove your self-confidence

Implants placed in front of the muscle give more weight to your breast and do sag more with time. Those placed behind the muscle have the support of the muscle which cannot sag. However, the muscle does not completely cover the implants and some large implants may slowly slip down with time.