Deciding on Breast Implant Placement: Over or Under the Muscle?

The decision to have breast augmentation doesn’t end after weighing the pros and cons of surgery. You need to make various important decisions involving the procedure including implant type and size, the location of the incision, and implant placement. These choices will be discussed and weighed during your face-to-face consultation with Dr. Herte, taking into account factors such as your age, body type, lifestyle, and aesthetic goals.

The implant placement decision
Currently, breast implants can either be placed over or under the pectoralis major muscle. While an experienced breast augmentation surgeon like Dr. Herte is the best person to consult with concerning the pros and cons of each placement, doing your homework before choosing between the two is also crucial. Let’s take a closer look at the two placement options.

Subglandular (over-the-muscle) placement
This type of placement involves placing the implant between the breast tissues and the pectoralis major muscle. Women who opt for a subglandular placement will enjoy the following benefits:

• Shorter recovery period because it is less invasive in comparison to implants placed under the muscle
• The implants do not become distorted when the chest muscles are flexed
• Cleavage is easier to create because the placement allows for the implants to be placed close to each other
• It’s easy for larger implants to be placed using the subglandular method

Subglandular placement has the following drawbacks:

• The resulting pronounced roundness may make the implants appear less natural; however some women prefer this look
• Visible rippling is more likely to happen because there is less coverage of the implants, particularly in the breast borders
• Increased risk of the implant bottoming out: this causes the implant to fall below the areola and the nipples to point up
• Increased risk of mammogram distortion
• Occurrences of capsular contracture are higher in this type of placement

Over-the-muscle placement is highly recommended for women who have well-defined chest muscles (professional athletes, bodybuilders) and have sufficient amounts of natural breast tissue.

Submuscular (under-the-muscle) placement
The submuscular placement inserts the implants partially beneath the pectoralis major muscle. Its advantages include the following:

• Reduced risk of bottoming out, visible rippling, and capsular contracture
• Solid support from the muscle
• More natural look and feel
• Risk of interference with mammograms is very low

Submuscular placement has the following drawbacks:

• Longer recovery period while the muscle adjusts and relaxes
• Flexing of the pectoralis major muscle is more noticeable
• Overly large implants are less likely to be utilized

Silicone gel implants are preferred by most patients because they work really well when placed under the muscle as they provide the most natural-looking results.

Schedule a consultation with Dr. Herte to learn more about your breast implant placement options. Call 702.732.9600 to set up an appointment.