Choosing Your Breast Implant Placement


When you make the decision to undergo breast augmentation that is only the first of many decisions you will be asked to make as you prepare for your procedure. One important choice is where you want your implants to be placed. The placement of the implant will have as much impact on the overall appearance of your breast augmentation as the type and size of implant you choose. It is important to understand the two options, as well as the pros and cons for each.

Above or Below?

Both saline and silicone implants can be placed above the pectoral (chest) muscle directly in the breast tissue, or underneath the pectoral muscle. There are numerous factors that will affect which of these placements might offer you the best possible results. Understanding those factors will help you make the best choice for you.

Above the Muscle

Over the muscle is also known as subglandular placement. The implant is placed between the breast tissue and the muscle. There are a some advantages to subglandular placement:

  • Appearance of the implant doesn’t change when chest muscle is flexed

  • Surgery is somewhat less invasive

  • Recovery from the procedure may be faster and less painful

There can also be some drawbacks to subglandular placement:

  • Breasts may be more likely to sag over time

  • Greater likelihood of visible breast rippling

  • Higher risk for capsular contracture

  • May not look as natural in smaller women

  • Higher chance edges of implant might show

  • Can make mammograms more difficult to interpret

As a general rule, subglandular placement tends to work best in women who have sufficient breast tissue to safely conceal the implant. It is may also be beneficial for women who are  bodybuilders to have their implants placed above the muscle since there is less distortion when the chest muscle is flexed. Textured implants are recommended for this placement, because the incidence of capsular contracture is lower.

Under the Muscle

Placement of the implant under the muscle is known as submuscular placement. In this case, the implant is partially placed under the pectoral muscle, giving the upper pole of the breast a more natural angle in some cases. Other advantages to submuscular placement might include:

  • Lower risk for capsular contracture

  • Provides additional tissue to conceal the implant

  • Reduced risk for visible rippling

  • May result in less distortion during mammograms

  • Less stress on the breast skin with decreased production of sagginesss over time

Women may also find the submuscular placement has a few drawbacks:

  • Distortion of the chest when the muscle is flexed

  • Surgery tends to be more invasive and take longer to complete

  • Recovery may be longer and more uncomfortable

Submuscular placement is frequently recommended for most women. The bottom line is that the placement of the breast implant is a personal choice that should be made between a woman and her plastic surgeon.

Article by
Cedar Rapids Plastic Surgeon