Breast Implant Placement: Over or Under the Muscle?

Should my breast implants go over or under the chest muscle? If you’re considering breast augmentation surgery, this is probably one of the questions that have come up in your research. It’s a question everyone undergoing breast augmentation surgery should ask. Since many factors play a role in which implant placement is right for you, it’s important to consult with your plastic surgeon.

Because everyone’s body is different, what is the right implant placement for one person’s breast augmentation surgery may not be right for someone else. Prior to breast augmentation surgery, your surgeon and you will decide on which implant placement is right for you. Let’s examine the differences and the pros and cons of both implant placement options.

What is an under-muscle implant?

Breast implants placed under the chest muscle are also known as submuscular implants. A thick band of pectoral muscles runs high up in the chest, extending from the shoulder to the breast bone area. One placement option during surgery is to put the breast implant under both the breast tissue and this muscle. This type of under-muscle implant placement softens the lines of the breast’s natural curves, preventing the implant “bulge” that was often visible in the early days of breast implants. Today, a much more natural look is able to be achieved, particularly with under-the-muscle placement.

This is typically the preferred placement for people with very small amounts of natural breast tissue. Then the muscle will help to conceal the implant so it doesn’t look unnatural or protruding. It can also provide additional support for the implant and hold it in place. It does however make the surgery a bit more complex and patients report a slightly longer recovery time than those with over-the-muscle implants. It’s also important to note that under-the-muscle placement can make the implant appear smaller, so this should be factored in when selecting implant size.

Pros of Under Muscle Breast Implant

  • Provides support and coverage of the implant
  • Helpful when there is a minimal amount of natural breast tissue
  • Can help create a more natural look

Cons of Under-Muscle Breast Implant

  • Recovery time may take longer with more discomfort
  • May make the implant look slightly smaller
  • Very small risk of dynamic distortion during muscle contractions, over time, implants can move due to muscle flexing, causing a loss of cleavage

What is an over-muscle implant?

Also known as subglandular implants, due to the implants being placed under the breast tissue, over-the-muscle implants are not as common as under-muscle implants. That’s due to the fact that in order for an over-the-muscle implant to look natural, there needs to be enough natural breast tissue already in place to cover the implant and smooth out its appearance. Since most women who seek breast augmentation don’t have this amount of tissue, under-the-muscle placement is usually preferable. However, there are some pros as well as cons to over-the-muscle implants worth considering:

Pros of Over Muscle Breast Implant

  • Is a good option for severely sagging breasts, since the muscle is too high up from where the breast lies for natural-looking under-the-muscle placement
  • Simpler surgery
  • Faster recovery with less discomfort

Cons of Over-Muscle Breast Implant

  • Requires ample natural breast tissue for the placement to look natural
  • Muscle doesn’t hold the implant in place and provide additional support
  • The rare condition Capsular Contraction is more common in over-the-muscle placement. This condition causes scar tissue to form around the implant
  • Can interfere with mammogram readings more so than under the muscle placement

Problems with Breast Implants Under the Muscle

The main concern with under-the-muscle implant placement typically is the increased recovery time necessary for this type of procedure. Patients may experience greater discomfort in the initial days after surgery and it may take longer to fully return back to normal activities. However, for many women, particularly those who have a bra size of a B cup or less, this is a worthwhile tradeoff because of the more natural look and concealed appearance of the breast implant. Dr. Cat’s gentle approach helps patients ease into recovery and every step is taken to ensure a patient’s optimal comfort.

There are some rare deformity issues such as Dynamic Distortion and Snoopy Deformity that occur more frequently with under-the-muscle implant placement. These issues caused by either the implants moving or the breast tissue moving away from the implant are not common and can be corrected with additional surgery.

Where are breast implants placed for best results?

As you can see, there isn’t a specific placement option that is “better” than another. Implant placement depends on a variety of factors such as the patient’s anatomy, lifestyle and appearance preference. Dr. Cat guides patients through their options during your in-depth consultation. While there are pros and cons to both types of breast implant placement, with Dr. Cat’s guidance, you can choose the placement that’s right for you.

Learn About Your Breast Implant Options in Beverly Hills

One of the perks of breast augmentation surgery is the number of choices you have when it comes to implants. Since all of these options can be overwhelming and sometimes a bit confusing, it’s important to have an experienced, informed cosmetic surgery team who can guide you through the decision-making process.

During your consultation with Dr. Cat, you can expect a relaxed, no-rush experience that allows you to ask questions and get answers. Here, Dr. Cat discusses implant type (silicone vs saline), implant placement (over or under the muscle), incision placement (in the crease below the breast or around the areola), and also size. “In my office, we have a wide range of sizes that you can put in your bra to see how they look on your frame,” explains Dr. Cat. “We’ve found this is the best way to pick your new size. I’ll have you feel the difference between saline and silicone breast implants and we talk about the differences. I will also perform detailed measurements and discuss the differences in the types of implant shapes.”

Having a plastic surgeon like Dr. Cat take the time to explore all of your options with you is an essential part of the breast augmentation process that allows you to fine-tune your procedure to suit your needs and lifestyle. If you’re considering breast augmentation surgery in Beverly Hills, schedule a consultation with Dr. Cat to begin the process and learn more about the procedure.