Can Breast Implants placed through the nipple also be placed under the muscle?

I am 50 and considering post menopausal breast implants as things have shriveled since menopause. I am considering through the nipple as I hear it is the best scar and always hidden when clothed. I also want it to be under the muscle. Can the breast implant go under the muscle from the nipple approach?

Doctor Answers 24

Can Breast Implants Be Placed Under The Muscle Through The Nipple?

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Thank you for your question!  You can absolutley have your implants placed under the muscle, through the nipple.  Find a board certified plastic surgeon who preforms these routinley.  Best of luck! 

Dr Dhaval Patel Double Board Certified Plastic Surgeon Chicago Hoffman EstatesOak Brook

Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 98 reviews

Submuscular Saline Implants with Peri-areolar Incision

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The #peri-areolar #incision is ideal for saline implants. They require a smaller incision because they are not filled until they are inside the body
Rippling of saline implants can of be experienced in patients who are thinner or leaner. However, this rarely occurs if the placement is #submuscular.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Circumareola approach used for submuscular implants

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Yes, implants can be placed using a circumareola incision and under the muscle.However, since your breasts are shriveled, you would benefit from a simultaneous skin excision.The goal of breast surgery is to create beautiful breasts.Beauty is determined by several factors including position of the breast on the chest wall, skin tone, symmetry, cleavage, position of the areola and volume.22% of women who undergo breast augmentation alone require revision within 2 years because they are dissatisfied with the result.Frequent causes of dissatisfaction are over implantation and not performing a simultaneous lift when needed.I recommend a new technique called Breast Augmentation with Mini Ultimate Breast LiftTM.Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.Through the same incision, implants can be placed.Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant.Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision.Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.5 out of 5 stars 229 reviews

Implants can be placed through the areola and under the muscle

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Yes, implants can be placed through the areola and behind the muscle.  All saline implants canbe placed this way.  For silicone implants, several things come into play to determine if the timpant can be placed through a peri-areolar incision: the areola diameter, the size of the implant, the projecton of the implant, the shell of the implant and the cohesiveness of the gel.  

However, I do not agree with your blanket statement that the areola scar is the best.  You should discuss the pros and cons of the different incisions with your plastic surgeon.

Michael B. Tantillo, MD
Boston Plastic Surgeon

Where to place breast implants

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thank you for your inquiry about breast implants.

Yes, implants can be placed under the muscle using an incision around the nipple.

The disadvantage is that this approach may increase the risk of a capsule (firm tissue) forming. Discuss the pros and cons of the peri-areolar approach with your Board Certified Plastic Surgeon. Best wishes.

Submuscular Implants Through Periareolar Incision?

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Yes, breast implants can be placed into a submuscular pocket through a periareolar incision.  This depends on the size of the areola and whether you plan to use saline or silicone implants.  Silicone implants are inserted fully inflated and require a larger incision and may not be possible if the areola is small.  Also, please be aware that capsular contracture risk appears to be higher when this incision is used and the risk of nipple numbness may be increased as well.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

The periareolar incision may increase the risk for capsular contracture.

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Implants can certainly be placed in a sub muscular position using the periareolar approach. However I am less inclined to go through the areola these days in that there may be a higher risk for capsular contracture. Dragging the implants from breast tissue which is a requirement of a periareolar approach subjects the implant to contamination by bacteria.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 41 reviews

Periareolar incision for breast augmentation

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Yes, breast implants can be placed under the muscle if the incision is around the nipple areola complex.  I would recommend that you consult with a board certified plastic surgeon to determine if this approach is feasible for you.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 21 reviews


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Yes, implants can be placed under the muscle (sub muscular) through a nipple (peri areolar) incision.  Although it is difficult to see any incision with breast augmentation, the peri areolar incision is a great option.  Your surgeon, however, should inform you that their is an increase risk of capsular contracture through this incision.  It is believed that contracture, or scar thickening around your implant, is the result of bacteria generating biofilm.  Disrupting the ducts can potentially allow bacteria to seed your implant.  Although the risk is low, I am using  the infra mammary position more frequently as the risk is the lowest.

Alberto Aviles, MD
Detroit Plastic Surgeon

Saline Breast Implants and smaller Silicone can be placed under muscle through Aerola

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Thank you for your question. Saline breast implants are frequently successfully placed beneath the chest muscle through a trans-areola incision.

With the help of the Keller funnel smaller silicone gel breast implants may be placed through the areola as well. However larger silicone gel breast implants are difficult to place through an areola incision because of the risk of tearing the skin.

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.