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

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

Once you decide to move forward with breast augmentation, one of the key decisions you will need to make with Dr. Lefkovits is whether to place your breast implants over the muscle (subglandular) or under the muscle (subpectoral). Each placement option comes with certain benefits and drawbacks that will be influenced by a variety of factors, such as:

  • The type of breast implants you choose (saline or silicone)
  • The size of breast implants you choose
  • How thin your natural breast tissue is
  • Your cosmetic preferences

Dr. Lefkovits will discuss your options in more detail during a personal consultation. Generally speaking, the three basic breast implant placement options are outlined below.

Over the Muscle

Also known as “subglandular” placement, this option involves placing your breast implants above the pectoral muscles in your chest. The benefits of supra-pectoral placement are:

  • More natural-looking in certain cases
  • Allows for larger size implants
  • Easier surgical procedure in some cases

However, when implants are placed over the muscle, the edges of the implant can sometimes be more visible, and the risk of visible rippling under the skin is also higher. Supra-pectoral placement can also involve a higher risk of capsular contracture or bottoming out in some patients.

Under the Muscle (Sub-Pectoral)

When implants are placed under the muscle, the pros are:

  • No implant visibility
  • Reduced rippling
  • Lower rate of capsular contracture
  • Strong, bra-like internal support

The drawbacks of this placement method are that it can often involve a slightly longer recovery time and a bit more complex procedure. Additionally, some patients will feel slight pressure during exercise as the muscles constrict around the implants.

Partially Under the Muscle (Partial Sub-Pectoral)

There is a third option for breast implant placement: positioning the implants just under the front part of the pectoral muscle, but leaving the lower insertion point of the muscle released so the bottom third of the implant rests below the edge of your muscle.

This method is a good compromise between the first two techniques, providing a natural look while reducing the rippling effect and lowering your risk of capsular contracture. While it does involve some risk of the implant riding “high” on your chest, and there is a still a slight possibility of bottoming out, these problems can be avoided in the right candidate.

Your body type and physical attributes – along with safety and aesthetic appearance – will all dictate which type of placement will work best for you. Dr. Lefkovits will make sure each option is thoroughly addressed prior to surgery.

If you have more questions about breast implant placement, please contact Park Plaza Plastic Surgery today or call (212) 750-9494 to schedule your consultation with New York City board-certified plastic surgeon Dr. George Lefkovits.