Over or under the muscle?

During breast augmentation surgery, breast implants are placed under the breast tissue or beneath the chest wall muscle. With either location, the implants will be properly centered under the nipple. The two placement options are defined as the following:

  • Subglandular placement: under the breast tissue and over the pectoralis muscle
  • Submuscular placement, i.e. below breast tissue and partially beneath the pectoralis muscle

The placement option chosen will be largely determined by the patient’s body type, tissue thickness, and lifestyle requirements. There are benefits and disadvantages associated with each location, but they differ in each case, so Dr. Samaha will discuss your options thoroughly in your consultation.

Under the muscle: pros & cons

For this placement option, the lower part of the pectoral muscle is released from the chest, and this muscle covers the top portion of the breast implant. This is the preferred option for many patients for a few reasons:

  • Provides better coverage for the implant
  • Reduces the chance of visible rippling and implant palpability (ability to feel the implant edges)
  • Helps to ensure that your breast tissue is fully viewable during a mammogram

However, this more involved surgery requires a somewhat longer recovery time before the implants have “settled” into their final position. Additionally, you may notice some movement of the implant when you flex your chest muscles. Most women say this feeling is strange at first, but nothing to worry about, as it doesn’t affect the permanent placement of the implant.

Over the muscle: pros & cons

Once the standard placement option, subglandular implant placement has generally lost favor among surgeons and patients, because having less tissue to cover the implant increases chance of visible edges & rippling. However, for certain patients, subglandular placement may still be a good option, and there are a few advantages. Because the pectoral muscle is left intact, recovery time is typically quicker. Additionally, your implants will not move within their pockets when doing chest exercises.