After choosing the size of the breast implants, the next question is where to place the implants. The majority of plastic surgeons insert the implants under the muscle because it may feel more natural. Also, some studies have suggested a lower incidence of capsule formation or hardening under the muscle. There are some surgeons who routinely place the implants above the muscle because they feel it may lead to a better overall shape.
At Dr. Lefkovits office, we believe that each patient should be individualized. If the patient has very little breast tissue then the doctor will go below the muscle so that there is more coverage of the implant leading to a more natural feel as well as look. This is true for the majority of patients.
However, if the patient has noticeable breast tissue accounting for at least a B cup then Dr. Lefkovits will often go above the muscle because it may lead to a more natural shape.
Also if the patient has extensive use of the pectoralis muscle as in body building I would probably go above the muscle to minimize trauma to the muscle.
Ultimately it is best to adhere to the advice of the operating surgeon. It is important that he be Board Certified in Plastic Surgery and have extensive experience with breast augmentation. If you would like to schedule a consultation at our New York City office, please contact Dr. Lefkovits today.