Breast Augmentation Over the Muscle vs Under the Muscle

There are two breast implant placements which your surgeon will discuss with you:

• Under the muscle breast implants (submuscular)
• Over the muscle breast implants (subglandular)

Breast implant positioning refers to their placement within the breasts in relation to the pectoral muscles behind the breasts.

Over the muscle breast implants are placed at the back of the breast, lying over the pectoral muscle, behind the mammary glands. Under the muscle breast implants are positioned within the pectoral muscle. Neither breast implant placement is preferable, and the decision is based on your natural anatomy and achieving your desired outcomes.

Over the Muscle Breast Implants

There are several reasons for choosing subglandular breast implant placement that your surgeon will discuss with you:

• Less invasive surgery: As incisions are not made in the pectoral muscles, Breast Augmentation over the muscle is typically takes less long and is less invasive
• Shorter downtime:  Due to the surgery being less invasive, the recovery time may be reduced
• Prominent projection: For patients who are looking for their breasts to look especially full, placing the breast implants over the muscle will extend them further from the breast wall

Our expert breast surgeons typically suggest over the muscle breast implants to patients who:

• Naturally have larger breasts: It is important to consider that your breast tissue needs to be able to contain the implants
• Want to achieve high projection breasts: As long as your breast implant size is compatible with your natural breasts, placing the implants over the muscle does create a more pronounced appearance to the breasts
• Want a larger implant size: Again, it is important to consider whether your natural breasts can contain a larger implant size, but for patients with adequate breast tissue, over the muscle placement is more suitable for high volume implants

Under the Muscle Breast Implants

Submuscular breast implant placement is the original Breast Enlargement technique. Surgeons suggest Breast Enlargement under muscle, where the implant is placed between the greater and smaller pectoral muscles for several reasons:

• Reduced risk of complications: Having the pectoral muscle acting as a barrier between the implant and breast tissue may reduce the risk of capsular contracture (excess scar tissue forming around the implant).
• Increased implant support: The pectoral muscles provide strong implant support, which decreases the chance of breast implant movement
• Enhanced breast contours: Placing the breast implant behind muscle can create a more consistent contour, resulting in a more natural appearance with the breast implant being less visible

Behind the muscle implants are usually suitable for patients who:

• Have naturally smaller breasts: For patients whose breasts are smaller and may not be able to contain the whole breast implant, submuscular breast implant placement is usually more suitable to prevent skin stretching
• Wish to achieve a more natural result: Placing implants behind the muscle achieves a lower projection, which looks more natural
• Have previously had problems with over the muscle breast implants: As there are fewer associated problems with breast implants under the muscle, for patients who are replacing their breast implants due to issues such as migration or capsular contracture, changing to submuscular breast implant placement with a Breast Implant Replacement may prevent complications from reoccurring

Dual Plane Breast Implants

Dual plane breast implant placement is an increasingly popular technique, which combines the benefits of above and below the muscle implant placement. The upper section of the breast implant is covered by the pectoral muscle, while the lower section sits beneath the breast tissue.

Surgeons typically suggest dual plane implant placement because:

• It produces a natural result: Dual plane breast implants often have a more natural appearance while still keeping the implant well supported
• Precision surgery: This placement allows the breast to be shaped very precisely for a highly bespoke outcome
• Reduced risks: For patients who are concerned about problems such as implant rippling ot capsular contracture, but who don't want a full submuscular placement, dual plane offers an effective balance

Dual plane breast implant placement is suited to patients who:

• Have some natural breast drooping: Dual plane breast implants are able to provide a slight lift to the breasts to treat sagging
• Are concerned about breast asymmetry: Due to the precision shaping, dual plane placement is highly effective for tackling asymmetric breasts

When deciding on the best placement for breast implants, it is crucial to bear your surgeon’s advice in mind. As well as considering your concerns and desired outcomes, they will also take into account which is the safest option for you to ensure you enjoy your Breast Augmentation results for many years.

A Note on Breast Implant Sizing

The size of your breast implants will significantly influence your breast implant positioning. If the implants you have chosen are too large to be contained by your natural breast tissue, you may be limited to under muscle breast implant positioning. Your surgeon will discuss these factors with you during your consultation.

Frequently Asked Questions