Under Vs over the Muscle Placement for Silicone Breast Implants?

Generally submuscular implants have many advantages. You should also be aware that there are many other factors that will determine the quality of your results. Much of the final “look” achieved after breast augmentation surgery depends on several factors:
 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation... more

There are advantages and disadvantages to both that must be understood for an intelligent decision to be made. First of all, as by other doctors, present day opinion (without scientific validation) favors a submuscular placement when considering the interpretation of mammograms. It is debatable that this is a major consideration. The placement of your implant will be determined during consultation with your doctor or physician. If a breast is tubular in shape or if it is modestly ptotic... more

Implants placed under the muscle tend to sit higher on the chest and give more fullness above the bra line. Implants placed above the muscle are more natural looking and tend to sit lower. Putting a 400 CC implant in someone of your cup size, height, and weight will probably put you into the full C cup range. Silicone implants don't ripple as much as saline implants ,and are the implant of choice when going sub mammary (above the muscle). This is the more common placement for patients in... more

Although there is no question what I would do for you, which is placing the implants partially under the muscle, your decision depends on the discussion between you and your plastic surgeon. I firmly believe that partially under the muscle yields a prettier upper breast look, especially in a thinner woman such as you. Look at your surgeon's before and after photos to see what you like. Best of luck. Dr Edwards

This is not generally an option that I give to patients. Based on her build and desires, I MAKE the decision to go under or over the muscle and RARELY do I go over the muscle. You really sound like someone who should go under the muscle, but I also think you're implant is probably too big for you!

Most surgeons prefer to place implants under the muscle for two reasons. First of all, in someone who is thin (like you seem to be given your height and weight), the muscle can provide an additional thin layer of coverage over the implant. Secondly, and most importantly, there is evidence that shows that there is a lower risk of capsular contracture when the implant is below the muscle. Since I have not examined you, I can't know if you have any reasons why it should not be put under the... more

In my practice, under or over the muscle depends on the patient and the breast tissue and appearance before implants. In your case, you sound quite thin and though silicone ripples less than saline, rippling in the upper pole can still be a problem, so I would usually go under the pectoralis muscle for more upper pole coverage of the implant.

Your surgeon should be helpful in your decision whether to have silicone gel implants under the muscle-subpectoral or under the breast-subglandular.Both methods of breast augmentation can provide pleasing results if done by a properly experienced board certified plastic surgeon.Submuscular breast implantation is an easier, less complex surgical procedure with less post operative pain. The coverage of the implant by muscle provides additional coverage of the implant which helps hide the... more

The choice of under or over should have been made in consultation with your surgeon. It sounds like you are thin so coverage will be an issue, which would be a factor in favor of going under. There are other options such as subfascial that are considered for athletic women who are at risk for muscle flexion deformities but this is also a decision that shouldn't be left to the last minute.

There are several factors which are important to consider when choosing pocket location. Above the muscle will give you a better projection but the implant could be visible if you do not have enough breast tissue coverage. Other issues to consider include family history of breast cancer and nursing. In case of doubt, you can always go under the muscle.

If you are planning to have surgery and still are not committed to, and convinced of, your choices, you should postpone your surgery. Breast augmentation is an elective procedure and you and your surgeon should be in sync with all aspects of the operation. Your decision will affect not only your immediate results but perhaps the future longevity of your breast appearance and the long-term side effects and potential complications, including chance of re-operation. While the procedure itself... more