Under or over the muscle ?

Now 32aa barely can fill it out , going for 400cc or 425cc . My doctor said over the muscle , but I'm thinking since my chest is so small/flat under would look better !!

Doctor Answers 16

Under vs over the muscle

Hard to give you an exact answer without seeing you and taking a history.  As a general rule in someone with very little breast tissue under the muscle creates more coverage over the implant and makes the chance of visible wrinkling or implant edge much lower, as well as having a more natural feel.  If you are an extreme athlete such as a rock climber, competitive weight lifter or someone who uses extreme upper body strength then consider over the muscle.


Jeremiah Redstone, MD

New York Plastic Surgeon
4.7 out of 5 stars 13 reviews

Under or over the muscle implants

Thank you for the question.  It is hard to say which would be better for you without pictures and an in-person examination.  Most doctors recommend under the muscle since it would stay in place while over the muscle could sometimes cause tissue damage because it will be carrying the weight and has a probability to sag with age.  It would be best to go with your doctor's recommendations since he or she would know your situation better. Best of luck Dr. Michael Omidi

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 95 reviews

Under the muscle

Without seeing you in person or a photo, it is impossible to say, but, in general, I would recommend under the muscle. You might want to get a second opinion from another board certified plastic surgeon in your area (link below). Best, Dr. Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

It depends on the amount of breast tissue

If you do not have a lot of subcutaneous tissue in the upper pole of your breast, placement under the muscle is a better option.  This is because the implant can be visible if it is placed over the muscle without much overlying tissue to cover it.

Justin P. Martin, MD
Dothan Plastic Surgeon
5.0 out of 5 stars 14 reviews

Ask your surgeon why they recommend over

There are several factors considered when determining implant position placement. Over the muscle can be suitable if you have a larger frame. A photo would be helpful to give you a better recommendation, but in general, under the muscle is preferable if you have less of your own breast tissue. This is because it provides more implant coverage to make the outline of the implant less visible and reduce rippling. It also provides better support over the long term so reduce the rate of sagging. I would suggest you ask your surgeon why they think over is better for you.

Leila Kasrai, MD, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 66 reviews


Hello dear, thanks for your question and provided information as well. I recommend you to have a consultation with a board certified plastic surgeon, location of the implant will be determined on surgery, or before, depending on each doctor

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.5 out of 5 stars 417 reviews

UNDER the muscle, some advices:

Thanks for the question.

I recommend a Breast Augmentation using microtexturized highly cohesive silicon implants, with high projection to fill the breasts properly, and placing them under the muscle, to get a natural look and long term best results.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

Deciding implant placement

Thank you for asking about your breast augmentation.

  • You have very small breasts and you are going to a large implant.
  • Your chest skin is probably tight - which means that you may be able to feel or even see the outline of an implant over the muscle.
  • For this reason, under the muscle would usually be recommended.
  • BUT if you are looking for a rapid recovery and immediate result - implants over the muscle hurt much much less and settle into position quickly - under the muscle implants hurt and can take months to settle in place.
  • I suggest you discuss the pros and cons of these two approaches again with your surgeon before making a decision.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Over or under

I prefer in the majority of patients to place implants under the muscle especially when they do not have a lot of soft tissue coverage. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Under or over the muscle

As with any action in life, there are advantages and disadvantages of going over or under the muscle when placing breast implants. In most cases, I place the implants in the sub muscular area. This reduces the risk of rippling and edges showing in the cleavage area. It may also have the advantage of giving a slightly better shape. In cases where there is thin breast tissue, I always advise patients to consider under the muscle placement. 

Rizwan Alvi, MBBS, FRCS
Liverpool Plastic Surgeon
5.0 out of 5 stars 7 reviews

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.