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The reason there are two separate ways of placing those implants in the breast tissue is that they do have their own advantages and disadvantages. The placement under the muscle is a very good placement. It's my preferred one. I rarely ever do them in front of the muscle, but sometimes I do. The reason to put them in there is because the implant seemed to have a protection against the capsular contraction.

You can ask what a capsular contraction is. A capsular contraction is when your body forms a barrier around the implant. It always does. Sometimes this barrier gets to be very thicker and it tends to tighten around the implants making them feel firm and unnaturally shaped. One of the ways to avoid that is to place them under the muscle, which is why I do that most of the time.

However the bad side is it tends to hurt a little bit more going under the muscle. Also if your muscle contracts, it will give you a little bit of a distortion. One of the ways to avoid that distortion is to divide the inferior insertions of the muscles, so there's not so much action into the implant as you contract the muscles.

Now there are some people that have very strong muscle and they will experience various degrees of distortion with contraction. Especially, let's say, for people that do body building, they tend to have very strong muscles, and sometimes we consider putting them in front of the muscle instead.

The placement of in front of the muscle has some advantages. Number one, it hurts a lot less. Number two, it tends to look good right away. When we go under the muscle, the implant tends to be located a little high to begin with and we have to wait for some time before the implant settles down into the right position. When it goes in front of the muscle, then the position will be immediate and the rewards would be instantaneous.

However the position in front of the muscle has a tendency to stretch the breast tissues more overtime. I've seen patients that, after pregnancies, they have stretched their tissue a lot to the point where their breast sags and they want to have corrective surgery for that. In that case, the correction will be to put them under the muscle and also to give the patient a lift, so the shape and form of the breast will be enhanced further.

Breast Implants Over or Under the Muscle: Advantages and Disadvantages

Dr. Juan Brou explains in detail the reasons why patients or surgeons would choose to place a breast implant over or under the muscle in the breast pocket, noting the advantages and disadvantages to both approaches.

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