I am 37 years old and have nursed my 3 children. I used to be a C cup, but now my breast are just “empty” and saggy. My surgeon says I am not quite needing a Breast lift, but is recommending Silicone Breast Implants above the muscle. I don’t know anyone with implants above the muscle. Is this the right approach?

William Bruno, MD answers: Is above muscle breast implant placement the best approach?

A: Breast implant placement

Most breast implants are inserted under the pectoral muscle (subpectoral). The reason for this is a lower rate of capsular contracture (scar tissue), more natural appearance, and easier mammogram interpretation. This is not to imply that over or in front of the pectoral muscle is incorrect, however there are many more advantages with the subpectoral approach.

In your particular case, the recommendation of placing the implant in front of the muscle is likely to avoid any need for a breast lift as the implant will help advance your breast tissue forward. As I look at your photo, it appears you would most likely do fine with a subpectoral implant-of course your surgeon has the benefit of being able to actually examine you, which I do not.

Please discuss this further with your plastic surgeon prior to selecting the implant location. This is elective surgery, so you have time to do your research and come to an informed decision.