Understanding Breast Implant Placement | Over VS Under The Muscle

If you have made the decision to undergo a breast augmentation, in addition to taking your time to select a highly qualified, board-certified surgeon, a number of important additional decisions need to be made, including your desired size, implant type, projection, and shape. In addition, it is necessary to determine the most suitable placement for your breast implants.

While your surgeon can help you understand the distinction between over and under muscle breast implant placement, the benefits and drawbacks of each technique are outlined below.

Over the Muscle Placement

The sub-glandular (sub-mammary) technique, frequently referred to as ‘over the muscle’ placement, involves positioning the implant between the chest muscle and the breast tissue. This position is considered to be less invasive and consequently, results in a shorter recovery time and reduced post-operative discomfort, as it does not disturb the muscle. In addition, more cleavage may be created if the implants can be positioned closer together.

Because of their placement above the muscle, implants will also not be impacted when pectoral muscles are flexed. This placement is particularly helpful to fill out and “perk up” a sagging breast when droop is not severe enough to require a breast lift. With more of the implant’s surface in contact with the breast tissue and skin, it is able to push out and round up the breast. However, for thin patients who have minimal breast and chest tissue thickness, the results may be less natural than the alternative, producing a more rounded, “augmented” look. While some women may prefer this outcome, individuals who are seeking natural results and have the option to do so, will usually prefer the under the muscle technique.

In addition, when skin and breast tissue is thin, sub-glandular placement can lead to visible rippling, as the implants are only supported by the skin and are covered by less tissue. The risk of capsular contracture is noted to be slightly higher.” Finally, mammogram screening may be more difficult which means more views will need to be taken during this type of testing.

Under The Muscle Placement

The sub-muscular (sub-pectoral) technique, known as ‘under the muscle’ placement, involves positioning the implants partially under the pectoralis major chest muscle. Because the implants are covered by existing breast tissue and the pectoral muscle, the results can be more natural appearing, particularly in the upper breast, and there is a lower risk of visible ripping. Patients who choose this technique are less likely to experience capsular contracture and distortion of mammograms. Despite its numerous advantages, under the muscle placement is a more invasive procedure and therefore, patients should expect a slightly longer recover time and more muscular discomfort post-operatively. For the first 4-6 weeks, the breasts may sit higher, until the muscle gradually relaxes.

In addition, when chest muscles are flexed, the implants may be impacted and lead to a degree of animation. In some instances, depending on the patient’s body size, very large implants may not be plausible with the sub-pectoral technique.

Although the decision to undergo a breast augmentation can be exciting, there are many important decisions to make when preparing for your surgery. During your consultation, your surgeon will work with you to help you establish the best implant placement for your individual needs and goals. To learn more and to schedule a consultation, please feel free to contact Edelstein Cosmetic today.




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