Over or under the muscle - Which implant placement would help me achieve a round shape with upper pole fullness? (photos)

Placing the implants above the muscle may in your case provide a better aesthetic appearance for the short term. There are many advantages to going under the muscle. Be sure that your surgeon thoroughly educates you as to the advantages and disadvantages of each location. This will allow you to weigh your options and make a decision on the best procedure for you.

Hi there, Thanks for your message. I would reccomend implants under the muscle for you. It would mask your implant better and give them a more natural looking apprearance. The fullness at the top of the breast you are looking for is from the shape of your breast pocket and can be achieved with an under the muscle implant also.Hope that helps! Good luck on your sugrical journey!

Thank you for your question, and based on your photographs, most likely an implant placed above the muscle would satisfy your goals. However, partial submuscular placement may be possible. I suggest you see a board-certified plastic surgeon experienced in breast enhancement to discuss your overall goals which will allow an appropriate discussion of options. Good luck!

I think over the muscle would work well for you. You would get a very natural result and there is less risk this way. Hope that helps. Best of luck!

Thanks for your question! I'm not sure that I agree that you have pseudoptosis. I think you have true ptosis, and my recommendation would likely include a breast lift in conjunction with a submuscular augmentation. I would suggest getting a second opinion if you aren't feeling 100% confident. Good luck!

Thank you for your question. I typically always recommend implants to be placed under the muscle. I find that implants look and feel much more natural, uphold a lot better long term and help with the upper pole firmness. I would suggest a breast augmentation with a silicone gel implant in a high profile with a breast lift. Best of luck to you.

Hello,
Thank you for the question.
Based on your photos, you appear to be a good candidate for subglandular (above the muscle) breast augmentation which can help correct slightly lower nipple position on you and prevent snoopy deformity in your case.
Implant size discussion and implant selection is one of the most important steps during your consultation with plastic surgeon. The decision-making process depends on patient’s desires, as well as breast and soft tissue dimensions.
I would encourage you to seek a consultation with a Board-Certified Plastic Surgeon to further discuss your options, specific techniques, concerns and expectations.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

You've got real ptosis, but regardless, going over the muscle for patients with any kind of ptosis only leads to dissatisfaction, along with the usual risk of higher rates of capsular contracture and implant palpability. Women who get their implants over the muscle to 'lift' their breast soon discover their breasts aren't so pretty: waterfall deformity. A modern, well-trained surgeon would never recommend over the muscle for ptosis of any kind, and a growing, overwhelming majority of surgeons place smooth round implants under the muscle in all patients. Your surgeon errantly diagnosed you with pseudoptosis and is making recommendations that aren't supported in the scientific literature. Consider finding a new surgeon.

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 if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

We as plastic surgeons try to avoid placing implants in front of the muscle now as we have seen an increase rate of capsular contracture in those cases. There are better techniques know (Dual Plane) which can give a similar outcome as over the muscle gives but still have some muscle coverage.

Judging by the photos you have uploaded, I would recommend a breast lift with placement of the implant in a dual plane. You have ptosis which will not be addressed without a lift. I dont like trying to avoid a lift by placing an implant in front of the muscle as the outcome long term is not favorable.

Hope that helps.