Why Are Breast Implants Usually Placed Under the Muscle?
by Roy Kim, MD
Breast implants are placed either above the muscle, under the muscle, or under the muscle fascia. The most common placement is under the muscle. The reason for this is because this maximizes the tissue over the breast implant and the edges of the implant, resulting in a more natural feel of the breast implant. Also, under the muscle placement allows for less rippling or wrinkling, which means less visibility of the implant.
Regardless of type of breast implant, saline or silicone, the placement of the implant is crucial in making the end result as natural as possible. The breast implant is usually placed under the muscle, also known as the pectoralis muscle. This ensures that maximal tissue is covering the breast implant, including the skin, soft tissue, and muscle.
The logic for under the muscle placement of the breast implant is to have the maximum amount of tissue covering the implant. This gives a more natural feel to the breast implant, and after healing, your breast feels extremely natural, just augmented.
A saline breast implant is harder than a silicone gel implant, so if both types of implants are placed under the muscle, the silicone gel breast implant still wins and is more natural feeling than a saline implant.
Every breast implant has the potential to have rippling or wrinkling. This is when you can feel or see the edges of the breast implant. To avoid this, you want to have more tissue coverage over the breast implant, which implies under the muscle placement for your breast implant.
Breast implants are usually not placed above the muscle.
There is an anatomic substance known as the fascia, which is a thin, clear whitish covering for the muscle. Sometimes the breast implant is placed above the muscle, but underneath the fascia. This is more commonly done in other countries, but is less common in the US.
Phew! A long anatomy lesson, but now you know why we prefer silicone gel breast implants placed under the muscle to give you the best aesthetic result in terms of feel of your breasts and avoidance of rippling and wrinkling.