I'm Considering Getting Breast Augmentation, is It Better to Get Submuscular?

i'm an A cup and would like to go to a nice full C, is it a better option to get submuscular for better looking and placement results?

Doctor Answers 27

Submuscular pocket position

This question is a matter of opinion amongst both surgeons and patients and I do not think that there is a definitive consensus. But, I personally think that the subpectoral or dual plane position is both more natural appearing and has fewer complications than the subglandular or subfascial positioning. There is evidence in the literature that supports the notion that capsular contracture rates are lower when the implant is placed under the muscle. I also feel that both the short term and long term aesthetic results are superior with the submuscular positioning. 

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 84 reviews

Submuscular vs. subglandular breast implants

Breast implants in general, especially saline breast implants, do not blend in well at their edges with surrounding tissue. For a more natural look it is best to place implants whose base diameter is slightly less than that of the overlying breast tissue. However A or AA cup patients have so little breast tissue there may be no breast base width to measure. The best option then is to place the implants under the pectoralis chest muscle in order to cover the edges with more tissue. The muscle edge is around nipple level though so the bottom outer edge of the implant is still at risk of being visible and that is the most common area to see rippling from the implant. In order to prevent the muscle from pulling the implant upward out of position the lower inner muscle fibers have to be divided at the time of surgery.

Constant firing of the muscle with movement after surgery seems to massage the capsule around the implant and decreases the rate/risk of capsular contracture. In the end the longer recovery and operating room for placing breast implants under the muscle is usually worth it.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews


There is no question that the submuscular (partial, total, or dual plane) is superior to the subglandular position. It gives better coverage. In terms of natural feel, you should consider silicone instead of saline.

Michael Hueneke, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 63 reviews

Sub-muscular breast augmentation

In my practice I perform the majority of my procedures in a dual plane were the superior portion of the implant is covered by the muscle and the inferior portion is covered by the breast tissue. I feel it give a natural appearance, reduces the chance of having a capsular contraction and increases the amount of tissue that is visible when undergoing a mammogram. In patients that are very athletic (mostly body builders) I would place the implants in a sub-mammary position to avoid displacement of the implants laterally due to contraction of the pectoralis  muscle.


Good luck!

Sub muscular vs Sub Glandular placement

Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Implant Selection Process

Submuscular will generally give a more natural look and slope to the upper pole of the breast.   In terms of size, In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 85 reviews

Breast Implant Types And Placement


As you may already know, you could have a saline or a silicone breast implant positioned:

  • Submuscular/Subpectoral with different positioning in that category as dual plane, partial or total.
  • Subfascial/Subglandular.


Usually, if the patient is looking for the most natural look with the least possible risks of capsular contracture the submuscular silicone implants are often considered.

However, to determine the positioning and the nature of the breast implants the surgeon and the patient have to agree on that subject after a thorough consultation and an "honest" communication to plan the surgery for the desired results.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.

I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.


Dr. Sajjadian 

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 197 reviews

Over or under the muscle for breast augmentation?

You are going to get many different answers for this open ended question.

It often times is a matter of preference. Each technique can have advantages in the right patient. For example, if you are thin, then over the muscle can ripple and you can feel the implant more....so under the muscle would likely be better.  For others, over the muscle is very good.

To discuss specific options and to tell what is best for you, see two or more board-certified plastic surgeons in your area for a full and complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery. I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 183 reviews


Submuscular (under the muscle) is preferable. This allows for the patient’s own tissue to better cover the implant, thus helping prevent rippling and show-through of the implant’s edge. Also, placement under the muscle allows for clearer mammograms and more natural aging of the breasts.


Tim R. Love, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 12 reviews

Submuscular breast implant placement


Thank you for your question.

Typically, I recommend a submuscular placement for patients who are
looking for a more natural appearance. They also tend to be the best
when it comes to mammograms. However, it is best to fully discuss your
options and expectations during a consultation with a board certified
plastic surgeon.

Good luck!
Dr. Sam Speron

Sam Speron, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 1 review

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.