Should Breast Implants Be Placed Under or over the Muscle?

Opinions certainly vary but among most Plastic Surgeons today the most common answer you will get is under the muscle.

Benefits include:


·         More tissue covering the Breast Implant

·         Less risk of Visible folds or Ripples

·         Less risk of firmness or capsular contracture


However Breast Implant under the Muscle can have disadvantages:


·         More painful and longer recovery

·         Visible muscle contraction around Implant during activity

·         Interference with Pushups and weight lifting

·         Higher position of Breast Implant which can cause unnatural look in sagging Breast

·         Requires Breast Lift with extra scars if Breast is sagging


Breast Implants are still placed under the Breast in many people and can produce an equally nice natural looking result. Reasons for choosing under the Breast include:


·         Easier Recovery

·         A slightly sagging Breast when you do not want to have a lift

·         Women with full Breast and adequate Breast Gland Tissue


It is wrong to be dogmatic and say there is only one way to place Breast Implants. You need to find an experienced Board Certified Plastic Surgeon and discuss your individual needs and preferences. See link below.

Hi, thanks for your question. In general, for a woman with a small amount of her own breast tissue, placing the implant "under the muscle" (behind the pectoralis major muscle) will look and feel more natural as the muscle provides an extra layer of tissue between the implant and the outside world. It is true that this position does make capsular contracture less likely, and provides a clearer view on mammography as well.

It's a great question. I strongly prefer under the muscle implants because the muscle provides another layer of camouflage for your implants. The muscle contours the top of the implant to give it a more natural slope and implants under the muscle have a decreased risk of scar tissue forming around the implant (capsular contracture).  Also, breast cancer screening with mammography gives better images of breast tissue when implants are placed under the muscle. Although an implant on top of the muscle can be a good choice for some women, for very thin women there is not enough camouflage for the implant to look natural. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide if breast augmentation is right for you.