Was advised over muscle as not a natural look fan, what's your view on over vs. under muscle implants?

"No key fits every lock" and your specific anatomy and goals are important. While going under the muscle probably helps avoid internal scarring or capsular contracture of the breast, and may make future mammograms easier, it is not the best operation for every patient.

Learn about the pros and cons in your specific case from a board-certified plastic surgeon to see which option is best for you.

The decision of whether to place breast implants under or over the pectoral muscle is a personal one and should be discussed with your plastic surgeon. Each of the solutions has benefits and drawbacks.

Submuscular (beneath the muscle) implants position can provide a more natural breast shape and seem more natural in contour, especially in patients with less breast tissue. It causes reduced ripples and less exposure of the implant margins, especially in people who are thinner. For bigger implants, under muscle position provides more and better support. However, because of the muscular manipulation they can require a lengthier recovery period. They may make increased discomfort during the first healing phase too. Finally, There's a slightly higher risk of capsular contracture, a condition where the implant becomes hardened.
The best option for you will ultimately rely on a number of variables, including your desired result, your body type, and the advice of your surgeon.
Generally speaking, body types with thinner chest walls and less breast tissue make better candidates for over-the-muscle breast implants. Since every person is different, the ideal option may vary depending on your intended implant size, skin elasticity, and general body composition.
It's critical to speak with a Board Certified plastic surgeon to go over your specific demands and choose the best location for your breast implants.
Hope this was helpful!
Best wishes,
Dr. Ali Sajjadian
TRIPLE Board Certified Plastic Surgeon

Dear Genuine973914,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Choosing between over or under the muscle for breast implants depends on the desired look and your body type. Over the muscle may appear less natural but has a simpler recovery. Under the muscle looks more natural and may have lower complication rates, but with a longer recovery. Your surgeon's advice seems tailored to your preference for a less natural look.

Both above and below the muscle can be made to look very natural or very not-natural to fit your goals, depending on the size/profile of implant, implant cohesivity, and your breast and chest wall shape. If going above the muscle, I do think it's important to place the implant subfascial (a modern above the muscle technique), as opposed to subglandular (the old above the muscle technique). Subfascial gets less capsular contracture, gives a better upper pole contour, prevents rippling, and gives better longevity than subglandular.

Thank you for your question. A large portion of my practice is dedicated to breast revision surgery and I have been in practice over 28 years. I have a whole gallery titled " chronic changes of implants placed on top of the muscle". Over the years, I see very few results that are attractive with time when placing implants on top of the muscle. In nearly all patients, eventually there is slide down the chest wall and a poor outcome. Listen to someone who has experience, place them under the muscle. Best wishes to you.

Hello,

Thank you for the question.

Typically, placing the implants above the muscle (subglandular plane) can help minimize animation deformity (when implants move during weightlifting). However, not everyone is a candidate for above the muscle breast implant placement because if the breast tissue are very thin, implant rippling may be more pronounced in the upper pole of the breast.

Placing implants over the muscle typically creates a more "natural" look versus under the muscle creates a more "augmented" look.

I would encourage you to seek a consultation with a Board-Certified Plastic Surgeon to further discuss your options, specific techniques, concerns and expectations.

I hope this helps.

Best regards, Dr. Karanetz
Dr. Irena Karanetz
Breast Fellowship-Trained
Board Certified Plastic Surgeon

Most surgeons advocate sub muscular implant placement. There is more soft tissue coverage, less change of capsular contracture and in general more support of the implants.

Most surgeons recommend under the muscle but some also do above the muscle especially in certain cases. So choose whichever you feel comfortable doing

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA