Is capsular contracture more or less likely with under muscle implants?

In very simple and plain words:-smooth or microtextured implants (first generations developed) have high rate of capsular contracture if located above the muscle-macrotextured or polyurethane coated (velcro) implants (latest generations) have even lower rates of capsular contracture in subfascial plane than submuscular, and can also be used subglandular though my recommendation is subfascialIt can be said that any implant shell in submuscular location is acceptable, though unnecessary nowadays with modern shell implants.I am for macrotextured or polyurethane coated shells in the subfascial plane, this allows the lowest rates of capsular contracture (nearly non existant) and less pain, less aggression and quicker recovery.

There are many featured that are thought to be associated with the incidence of capsular contracture, including the type of implants used, the implant coating, bleeding during the augmentation surgery and many other factors. An important study some years ago suggested that placing implants below the muscle may be associated with a lower risk of capsule formation. I would suggest having a discussion with your surgeon to evaluate this further, as the implant position will also impact on the aesthetic outcome.