Should Breast Implants Be Placed Under or over the Muscle?

If you were looking for a more "natural look", I would suggest placing breast implants underneath the muscle. The muscle serves to camouflage the upper part of the breast implant. This leads to a more natural breast shape where the slope of the breast extends in a straight line from the chest wall to the nipple. If you are looking for more fullness in the upper portion of the breast, I would suggest placing the breast implant above the muscle or in a subglandular position. In addition, if you are looking for more breast cleavage, I would suggest placing the breast implants in a subglandular or above the muscle position.

This is a good question as the majority of patient that wish
to have a breast augmentation desire a result that is going to feel and look
natural.



In the United States the vast majority of breast
augmentations are performed over the muscle.
However there are certain situations where the implant is placed over
the muscle. The benefits of placing the
implant below the muscle:

1.More natural feel

2.More natural appearance

3.Less visibility of the implant

4.Placing the implant below the muscle also
decrease the chance that the patient will form scar tissue around the implant.





The attached video explains the process of breast augmentation
and goes into depth about the benefits of placing the implant above and below
the muscle.



It is important to see your board certified
plastic surgeon to help guide you to an implant that will give you an
aesthetically pleasing breast.

It is almost always better to place the implants under the muscle. It gives another layer of coverage over the implants, which reduces the risk of rippling, and implant edge visibility. It is easier to perform mammograms, the risk of capsular contracture and implant infection are lower, and the likelihood of normal breast feeding is higher with the implant under the muscle.

Hi, thanks for your question. In general, for a woman with a small amount of her own breast tissue, placing the implant "under the muscle" (behind the pectoralis major muscle) will look and feel more natural as the muscle provides an extra layer of tissue between the implant and the outside world. It is true that this position does make capsular contracture less likely, and provides a clearer view on mammography as well.

It's a great question. I strongly prefer under the muscle implants because the muscle provides another layer of camouflage for your implants. The muscle contours the top of the implant to give it a more natural slope and implants under the muscle have a decreased risk of scar tissue forming around the implant (capsular contracture).  Also, breast cancer screening with mammography gives better images of breast tissue when implants are placed under the muscle. Although an implant on top of the muscle can be a good choice for some women, for very thin women there is not enough camouflage for the implant to look natural. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide if breast augmentation is right for you.

Hello,Thank you for your question. The answer to this is really patient specific. In a primary augmentation for someone with firm skin and small breasts, sub pectoral placement makes the most sense for many reasons, including less palpability and a more natural look. The animation deformity which can present itself is a drawback to this position. In very thin patients with thin breast skin, rippling may be seen or felt in the lower breast pole regardless of placement because this portion of the implant will not be covered by muscle either way. For my patients who have adequate fat and breast tissue and a slightly deflated or drooping breast appearance, I may recommend sub glandular placement instead to provide a perkier look. This advice is based on an in-person exam and detailed discussion of the patient's aesthetic goals.I recommend that you let your plastic surgeon know what you want to achieve and what your concerns are when choosing implant placement.All the best