Above or below the muscle for small (~250cc) implants ? (Photo)

Question

I’m interested in a BA to add a modest amount of volume and correct the sagging shape + wrinkles in my small breasts after weight loss. The first picture shows my current breasts and the following show my ideal breasts- I love weight lifting and ashtanga yoga where I practice a lot of handstands& backbends which engage and stretch the pec muscles which technique would you recommend? Would submuscular lead to animation deformity with my current physique?

Donald R. Revis Jr, MD · Answer

Good morning,
I am a strong believer in under the muscle placement- they look better, feel better, last longer, have a lower CC rate, and mammograms are better. With proper placement animation deformity is a minimal risk. You are an excellent candidate for breast augmentation, under the muscle, through a nipple or crease incision, and the 250cc range sounds right on. We would determine the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office!

Daniel Barrett, MD · Answer

Dear Yoginibb,
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

Adam Tattelbaum, MD · Answer

Thanks for your question and the photos. In a slender patient such as yourself a sub muscular implant will tend to look softer and more natural. You don't have a lot of natural tissue to help hide the implant. Implants under the muscle also tend to have lower contracture rates, lower infection rates and clearer mammograms when the time is right.

When the pecs are flexed the implant will be pushed and look "less" natural, but I think of this as a consequence of an implant below the muscle, not a deformity.

Hope this helps.

When the pecs are flexed the implant will be pushed and look "less" natural, but I think of this as a consequence of an implant below the muscle, not a deformity.

Hope this helps.

Ali Gurlek, MD · Answer

Thank you for your Question. 
there are multiple factors influencing the actual size increase a breast implant will provide other than volume, including:
Implant profile (projection) and base widthImplant shape (i.e., classic round, teardrop shaped, extra upper pole fullness)How much natural breast tissue you haveThe width and contour of your rib cage

Connie Hiers, MD, FACS · Answer

I recommend placing the implants behind your muscle for better coverage and support. Otherwise, the edge of the implants may be visible. With flexion, the animation is usually not too visible in normal clothing. If you wear tight and minimal clothing to class, then it will be seen.

Above or below the muscle for small (~250cc) implants ? (Photo)

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