Why does placement of an implant over the muscle have an increased risk of capsular contraction?
Data about increased capsular contracture higher in subglandular augmentation are mostly older data before the new cohesive gel implants. The new implants along with the no touch technique using triple antibiotic solution have greatly reduced capsular contracture rates. The key is that you need adequate breast tissue to cover the implant. A pinch test of the gland can be done and if you have more than 2 cm of gland thickness -especially on the left smaller breast-then you can have a sub glandular implant. Please read below about the no touch technique:
Anatomical implants with 5th generation cohesive gel above the muscle may be a good option for you and there is no evidence to suggest that these implants have an increased chance of capsular contracture. You need to consult with a PS who can examine you and run through the pros and cons with you. Implants above the muscle thin the breast and skin and implants under thin the muscle with time.