Where does the pectoral muscle stop on the bottom when placing an implant under the muscle? Having surgery next week, nervous!

I'm planning on getting smooth, round, 485cc implants and I have very little tissue. I'm concerned with how the bottom of the implant will look. Are the implants totally under the muscle? If so, how are they still soft and "boob" feeling? If the muscle bisects the implant somewhere, where is it attached on the bottom and would it look weird when flexing the pectoral?

Doctor Answers 8

Muscle only covers part of an implant

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Thanks for your question. The inferior portion of the muscle is released which allows the creation of the subpectoral pocket. Depending on the original shape of the breast, some of the gland might also be released to create a dual plane. Regardless, the inferior most portion of the implant will usually be palpable b/c it is not covered by muscle. Best of Luck!

Austin Plastic Surgeon
4.8 out of 5 stars 92 reviews

Where does the pectoral muscle stop on the bottom when placing an implant under the muscle? Having surgery next week, nervous!

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The pectoralis muscle attaches to the fifth rib.  During submuscular breast augmentation the bottom attachment of the pectoralis muscle to the rib is detached so that the bottom of the breast implant protrudes beneath the muscle.  Normally with pectoralis contraction there is slight compression of the implant..  The type of bulging and animation deformity you are worried about happens when too much of the pectoralis is detached and the implant falls below the plane of the cut edge of the muscle.  Normally a supporting sling of muscle was left intact on the side and near the breastbone to prevent this.

Implants under the muscle

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The subpectoral placement of silicon gel implants is the most common technique currently used. It helps nor only decrease the incidence of capsular contracture ,but allow a nice cosmetic appearance of the implanted breast, especially when you have little amount of breast  tissue to start with . The muscle covers the upper 50-60% of the implant ,allowing the breast implant to nicely contour the breast shape and contour .

Michael H. Wojtanowski, MD
Cleveland Plastic Surgeon
4.9 out of 5 stars 13 reviews

Where Does the Pectoral Muscle Stop?

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Thanks for your question! In doing a SM breast augmentation, the dissection of the pec muscle stops either 2/3 of the way down the sternum (my preference) or halfway down the sternum. This allows for some SM coverage, & some SG coverage, & is called a dual plane approach, which is the gold standard in my opinion of doing thousands of augmentation surgeries. Unless you are a body builder,

I would go with this approach, & not be nervous & not look back! Best of luck to you!

Robert P. Schmid, MD
Lubbock Plastic Surgeon
4.8 out of 5 stars 41 reviews

Where does the pectoral muscle stop when an implant is under the muscle?

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In general, most implants that are under the muscle aren't really totally under the muscle. The muscle is divided at the bottom and it tends to slide up and retract so only about two thirds of the muscle is covering the implant at the bottom of the implant covered only by breast tissue and skin. This allows the breast to be more rounded and more aesthetically pleasing. However, when the muscle flexes it tends to shift the implant to the side until the muscle relaxes. This might be an issue in bodybuilders and patients who compete in shape competitions. In general, relatively large implants in a small framed patient with little fat and support under the breast can bottom out with time. The size that you desire versus the long term appearance has to be balanced. Discuss this with your plastic surgeon.

Gustavo E. Galante, MD
Schererville Plastic Surgeon
5.0 out of 5 stars 55 reviews

Where does the pectoral muslcle stop

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- The final location of the pectoral muscle can vary ranging from the bottom of implant to the top of implant. it’s dependent upon muscle and breast anatomy, and amount of disection of the pectoral muscle to obtain a good ascetic result.  Always, refer to your board certified plastic surgeon on any questions.

Submuscular or subpectoral breast augmentation (breast implants)

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Many board certified plastic surgeons mention that breast implants can be placed under the muscle or over the muscle. Most surgeons these days place them under the muscle. But under the muscle doesn't mean entirely under the muscle. The implants are often placed through the inframammary fold (or in the natural fold under the breast). In order to get the implants in and to have it look nice, the muscle is released just above that natural fold.  This allows the implant to drop into position. Most surgeons do some type of a dual plane technique which means most of the implant is under the muscle but some of the lower implant is not.  This also happens to be where the natural tissue is thinnest (especially in a skinny girl).  So some girls can feel there implant in the lower part of the breast more than in other areas.  Also if the pectoralis muscle contracts after surgery, it can be a little visible. I advise my patients to chose a reasonable size for an activity that they do every day. Choosing too large of an implant can stretch out the tissue over time. The majority of the patients with breast augmentation are really very happy with the outcome and appearance. Good luck on your journey!

Breast Implant Questions

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This is something your surgeon should have discussed with you. No, the bottom portion of your implant will not be under muscle; and the larger the implant, the less the muscle covers the implant. Dynamic deformation of the breast due to effects of muscle contracture on the implant, although not common, is not rare either, and is also associated with larger implants. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.