Implant Placement: Over vs. Under the Muscle and Breast Implant Size

Breast implant surgery has become one of the most popular cosmetic procedures worldwide, offering individuals the chance to enhance their body contours and boost their confidence. However, one of the most critical decisions in the process—besides choosing the right breast implant sizes—is deciding on the placement of the implant itself: over or under the muscle.

If you’re considering breast augmentation, understanding the pros and cons of each placement method can help you make a well-informed choice that aligns with your body type, lifestyle, and aesthetic goals.

Selecting the right breast implant size and placement is essential to achieving natural-looking results and long-term satisfaction.

Over the Muscle Breast Implant Placement (Subglandular)

In the over-the-muscle technique, the breast implant is placed directly behind the breast tissue but in front of the chest muscle (pectoralis major).

What is Subglandular Placement?

Subglandular placement (commonly known as over the muscle) means that the breast implant is positioned directly behind the natural breast tissue but on top of the chest muscle (pectoralis major muscle).

Key Points:

The implant is under the breast glands but above the muscle.
It's typically recommended for women who have a moderate amount of natural breast tissue to cover the implant.
It offers faster recovery and less postoperative discomfort because the muscle is not disturbed.
It can create more prominent cleavage and a fuller look.
There is a higher risk of rippling or visible implant edges, especially in women with thin tissue.
The implant may feel less natural and has a slightly higher risk of capsular contracture (scar tissue hardening).

Suitable For:

Women who already have enough breast tissue to provide coverage.
Those seeking a rounder, more augmented look.
Patients wanting a shorter recovery time.

Pros:

Shorter Recovery Time: Patients usually experience less postoperative pain and a quicker recovery because the chest muscle is not disturbed.
More Defined Cleavage: Implants tend to appear more prominent and can create a fuller, more noticeable cleavage.
Easier Surgical Procedure: Surgeons generally find this technique less complex and quicker to perform.

Cons:

Higher Risk of Rippling: Because there’s less tissue covering the implant, rippling or visible implant edges may be more noticeable, especially in patients with thin skin or minimal breast tissue.
Potential for Less Natural Feel: In some cases, the implant may feel less natural to the touch, particularly if there's not enough soft tissue coverage.
Increased Capsular Contracture Risk: Some studies suggest a slightly higher chance of capsular contracture (scar tissue hardening around the implant) with over-the-muscle placement.

This option may suit women who already have an adequate amount of natural breast tissue to cover the implant and those seeking more dramatic volume enhancement.

Under the Muscle Breast Implant Placement (Submuscular)

In this technique, the under muscle breast implant is positioned beneath the pectoral muscle. This approach is highly favored for a more natural appearance.

What is Submuscular Placement?

Submuscular placement (commonly known as under the muscle) means that the breast implant is positioned partially or fully beneath the pectoralis major chest muscle.

Key Points:

The implant is covered by both the breast tissue and the muscle.
Provides a more natural appearance and feel because the muscle offers extra coverage.
Lower chance of visible implant rippling.
It typically reduces the risk of capsular contracture.
It can interfere less with mammogram readings, making it easier to detect breast abnormalities.
Recovery can take a bit longer and there may be more post-surgical discomfort.
Some women may experience "animation deformity" where the implant moves or changes shape when the chest muscles contract.

Suitable For:

Women with minimal natural breast tissue.
Those seeking a more natural, subtle enhancement.
Patients looking for long-term safety and reduced risks.

Pros:

More Natural Look and Feel: The extra muscle coverage softens the edges of the implant, making it less likely to be seen or felt.
Lower Risk of Rippling: The muscle provides an additional layer that helps mask any rippling of the implant.
Reduced Capsular Contracture Risk: Submuscular placement has been associated with a decreased chance of capsular contracture.
Better Imaging for Mammograms: Implants under the muscle interfere less with breast tissue, allowing for clearer mammogram readings.

Cons:

Longer Recovery Time: This procedure can involve more discomfort and a slightly longer healing period due to muscle involvement.
Animation Deformity: In some cases, the implant may move unnaturally when the chest muscle contracts, which can be noticeable during physical activities.
Less Pronounced Cleavage: Because the muscle holds the implant in place more tightly, the cleavage may appear less prominent compared to over-the-muscle placement.

This method is often recommended for individuals with minimal breast tissue, those aiming for a more natural look, or those who prioritize long-term safety.

Breast Implant Size Selection: Does Placement Affect It?

Breast implant size selection is one of the most personal decisions in breast augmentation. The placement of the implant can impact how the size appears post-surgery. For example, a 300cc implant may look larger when placed over the muscle compared to under the muscle, where the chest muscle compresses the implant slightly.

When considering breast implant sizes and shapes, it's essential to work closely with your surgeon, who will assess your body frame, chest width, and aesthetic goals to guide you toward the most appropriate option.

Quick Comparison About Implant Replacement

Feature	Subglandular (Over Muscle)	Submuscular (Under Muscle)
Placement Location	Over chest muscle	Under chest muscle
Appearance	Fuller, more defined cleavage	More natural, softer look
Recovery Time	Shorter	Slightly longer
Risk of Rippling	Higher	Lower
Risk of Capsular Contracture	Slightly Higher	Lower
Mammogram Interference	More	Less
Risk of Animation Deformity	None	Possible

Which Option is Right for You Over vs. Under the Muscle?

The choice between over or under the muscle placement depends on several factors, including:

Your body type and natural breast tissue volume
Lifestyle (high-impact sports may favor one option over the other)
Desired aesthetic (natural vs. enhanced look)
Personal and medical history

A board-certified plastic surgeon will provide tailored recommendations based on these elements to ensure optimal outcomes from your breast implant surgery.

Breast augmentation is a highly customizable procedure, and the decision regarding implant placement is just as significant as choosing breast implant sizes or the type of implant itself. Both over and under the muscle techniques have their unique benefits and potential drawbacks, and understanding them is the key to making an informed, confident decision.

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If you’re considering breast implant surgery and want professional guidance tailored to your needs, FlyMedi is here to help. Our trusted network of certified clinics and expert surgeons will support you every step of the way, from consultation to recovery.

Contact FlyMedi today to start your journey toward your ideal body confidence with the best breast augmentation options available.