Will having the implant under or on top of the muscle affect how far apart my breasts will sit?

Will having the implant under the muscle mean I will have a gap in the middle and therefore they will sit far apart

Doctor Answers 1

Will having the implant under or on top of the muscle affect how far apart my breasts will sit?

Thank you for the question.   

There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well.


I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). "Purely cosmetically speaking", I think that breast implant placement in the sub glandular position (over the shorter or longer term) tend to be associated with more problems with visibility (rippling) or palpability.  Basically, the more coverage we have overlying breast implants, the better the long-term look/feel seems to be. 



The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.    



Some general thoughts regarding "cleavage concerns" may also be helpful to you and other young ladies considering breast surgery:


Patients undergoing breast augmentation should understand that their anatomical “starting point” will play a significant "role" in the outcome that they can expect with breast augmentation surgery.   If the patient starts out with a significant distance between the breasts, there are limits as to how close of "cleavage" can be achieved.  If over dissection (when developing breast implant pocket) occurs in the cleavage area, with the goal being to achieve as close as possible cleavage per patient's request, patients may experience significant problems such as breast implant displacement (medial  malposition or symmastia) and/or significant breast implant rippling/palpability.  Obviously, these types of problems may require revisionary breast surgery to correct.  


Also, keep in mind, that each nipple/areola complex must remain centered on each breast mound after surgery.  Again, careful dissection of the breast implant pocket and appropriate selection of breast implant size/width/profile will also play a role when it comes to how close the cleavage area will be postoperatively (and the overall shape/symmetry of the breasts). Careful measurement/dimensional planning plays a big role in this regard.

 Best wishes for an outcome that you will be pleased with long term.

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.