Why is There a Greater Risk of Leakage with Breast Implants Placed Under the Muscle?

Some surgeons recommended implants placed under the pectoral muscles, but what about leakage?

Doctor Answers 19

No association between implant location and leakage

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There are no scientific studies that suggest that submuscular placement will lead to greater probability of implant failure. Consult with 3 - 4 experienced and expert board certified plastic surgeons to explore your options and review the relative advantages and disadvantages of your choices in implant position.  

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Breast Implant Failure Unaffected By Anatomic Location

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I am not sure where you have gotten the impression that the risk of breast implant failure is affected by its anatomic location. There has never been any evidence that this is true nor would there be a biologic or device explanation for it. There are several advantages and disadvantages for each implant location, either above or below the muscle, but implant failure is not one of them.

Does Implant Placement Affect Rate of Deice Failure?

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I have never read any scientific studies that show that implants have a higher failure rate (leakage) when they are positioned above or below the pectoral muscle. You should discuss pocket placement issues with your surgeon . It is best to come to your consultation with an open mind so as to take advantage of your surgeon's experience and education when it comes to technical issues about the procedure. Good luck.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Breast implant placement not associated with increased incidence of leakage

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I'm afraid you might have been misinformed. There is no evidence (that I have ever come across) that states there is a greater risk of leakage with submuscular implant placement. Personally, I prefer placing breast implants under the muscle

  • less risk of capsular contracture
  • increased support (not just skin envelope keeping them in place)
  • more natural appearance

I hope this helps, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Implant leakage

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I have never heard of an increased risk for leakage by putting the implants under the muscle.  The pros and cons of either placement are well documented by my colleagues, but this is not one  that I am aware of. Good luck.

Leakage after breast implantation/augmentation

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There is no impact of implant position on leakage rate reported in the plastic surgery literature. There are pros and cons of placing the implant above and below the muscle. Most implants are placed below the muscle but I believe there are some instances when placing the implant above the muscle has advantages. 

However the leakage rate is the same no matter where you place the implant. 

Jay Burns, MD
Dallas Plastic Surgeon
4.6 out of 5 stars 47 reviews

Leakage of implants

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As far as I am aware, there is no increased risk of breast implant leakage if the implants is under or over the muscle.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast implant failure under the muscle

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Smooth implants have a much lower rate of leakage than textured implants. You can't compare apples and oranges I don't put the smooth implants over the muscle because of the increased risk of capsular contracture. Mentor warrants the implant for life but does not pay more than a set amount which can be applied toward the surgical and facility fees but is not equivalent to the actual cost.

Breast Implant leakage

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Breast implants can develop small holes or tears and leak or deflate.  The incidence is very low and the United States manufacturers (Allergan and Mentor) offer a full warranty for any broken implant which includes financial reimbursement for the cost of the replacement surgery.  There is no greater risk of leakage related to implant position, either above or below the muscle.

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 83 reviews

There is NO increased leak rate when Breast Implants are Placed UNDER the Chest Muscle

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Breast Implants can be placed through 4 incisions (periareolar (lower portion of the areola), inframammary (breast fold), transaxillary (arm pit) and transumbilical (belly button). The implants may be placed under the breast tissue (over the muscle) or under the muscle (subpectoral  which is under BOTH the breast and the pectoralis major muscle). There is NO evidence whatsoever that placing the implant under the muscle is associated with a higher leak rate.

Placement under the muscle better covers implant ripples along the top of the breast, makes mammography easier, is associated with a lower rate of capsular contracture, among other benefits.

If you are confused, get more information by reading more or getting a second opinion. You must educate yourself before having surgery.

Good Luck.

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.