Answers
"I am interested in having my breasts enlarged. Which is better—implants under the pectoral muscle or over it? It seems to me that if they are over the muscle, the implants could sag over time due to their weight and the elastic property of skin. Also, is it possible to have a facelift and breast lift done at the same time?"
— Answered by James C. Grotting, MD
Birmingham, AL
There are a variety of factors that influence the decision of whether implants should be placed above or behind the pectoral muscle. In women who are relatively thin with minimal breast tissue above the nipple, saline implants are better concealed behind the muscle and the appearance may be more natural. On the other hand, women who have some drooping of the breast gland and thicker fat above the nipple often will get a better lifting effect from placing the implant on top of the muscle. The larger and heavier the implant is, the more gradual stretching of the skin and breast you will have over time. You will want to discuss these and other factors – such as how implant placement may affect mammography -- with an ASAPS-member plastic surgeon. In healthy patients, breast and facial surgery can be safely done at the same time.
