Is subglandular/over the muscle becoming more popular again? (Photos)

You bring up an interesting question. I have seen a slight increase in the number surgeons placing implants in the subglandular position. In the vast majority of cases, I still prefer to put implants under the muscle, and I think you would be an ideal candidate for a sub pectoral implants position. It's critical to choose a surgeon who is certified by the American Board of Plastic Surgery and has extensive experience with breast augmentation.  Check their before and after photos!Best,Dr. Gabbay

Over the muscle gel implants can give a very natural contour and a little more lift effect. Also better in serious weight lifters.In thin women, higher filled Sientra gels are a good choice.An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations. 

This is a great question! Subglandular augmentation is not trending up. While subglandular augmentation is the textbook answer for body builders, I have performed submuscular augmentation in body builders without any issues. The problems with subglandular augmentation is that smaller breasted patients don't have good coverage over the implant, so the implant may be visible under the skin; risk of capsular contracture is higher; and the implant will put weight directly on the breast tissue, exacerbating breast sagging and nipple areolar spread. It may be right for you - just make sure you get all the information you need.

Thank you for sharing your question and photographs.  There are both pros and cons to either subglandular or submuscular placement of implants but I do feel that most women, especially thin ones, benefit more form placement below your pectoralis.  Be sure to seek out a series of consultations so that you can make the best decision for your specific goals.  Best wishes.

Under the muscle placement is still performed more often than subglandular placement by most plastic surgeons. The fact that your pecs are so developed does not mean you can't have under the muscle placement. I have a couple of triple crown body builders who have submuscular implants with no issues. Patients are advised of the possibility of the implants “dancing” or animating at the moment the pecs are flexed; the implants immediately return to their resting position when the muscle is relaxed. This sometimes can be seen and rarely felt. I hope this information is helpful and reassuring. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

In my practice, I almost never perform a subglandular augmentation.  The submuscular position is superior for mammography, diminishing rippling, and decreasing contracture.  However, there will be some pectoral distortion in some cases especially in body builders.

Sophia,Thanks for the question.There seems to be a small trend to place some implants subglandular vs submuscular.  I place most of my implants submuscular, but I generally use the subglandular placement in certain conditions:Body builders, Very active individuals, many asymmetries, wide cleavage, droopy breasts and several others.There are good and bad points to either placement.  You need to weigh all of your options and go fro several consultations to make your final decision.Best of luck.Dr T

Implants can be placed above or below, but above in a very thin patient may result is early rippling and visibility of the implant, and smooth silicone are found to have  higher contracture rate above the muscle.

Most patients opt for the subpectoral augmentation to achieve a more natural appearance, lower risk of capsular contracture, etc.  Limited coverage of the implants in a very thin woman is another consideration.  You would need to be examined to assess the accuracy of the concept that your pectoralis muscles are too well developed and would create problems for a subpectoral approach.

Thank you for the question.  Yes, I think that there may be a trend where breast implants are being placed more so in the sub glandular position. 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.  Given your body type, I would recommend that use of these sub muscular position for you. 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). 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 the sub muscular position.    Best wishes with your upcoming surgery.