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Under or Over the Pectoral Muscle: Where Should I Place My Breast Implants?

breast implant placement

There are a lot of variables when it comes to breast augmentation. The size of the implants will vary from woman to woman. Implant shape also varies. And let’s not forget that you also have two major options when it comes to implant material, either silicone or saline.

One factor that also influences the results of breast augmentation, but that few people really think about, is breast implant placement. Typically, the implants can be placed either over the chest muscle (sub-glandular) or under the chest muscle (sub-muscular). There’s no one “right” breast implant placement, although some surgeons often prefer one method over the other.

Understanding Breast Anatomy

Having a basic understanding of the structure of the breasts and chest area will help you better understand the difference between a sub-muscular and a sub-glandular breast implant placement. The lowest layer of your chest (before the internal organs) is the rib cage. On top of the ribs is the pectoral, or chest, muscle. On top of the muscle is the glandular breast tissue and any fat. On top of that fat and glands is your skin.

An implant that’s placed over the chest muscle is sandwiched between your actual breast tissue and your chest muscle. Meanwhile, implants placed beneath the muscle are sandwiched between the muscle and your ribs.

Benefits of Under the Muscle Breast Implant Placement

Under the muscle breast implant placement is often recommended for women who don’t have a lot of natural breast tissue. Putting the implant beneath the muscle helps create a more natural shape in women who might be an A-cup or smaller. The muscle helps mask the appearance of the implant, creating a more natural look. Without the extra padding provided by the muscle, some women would end up with very round, fake-looking breasts, which isn’t the what many women want.

Along with providing a more natural shape, under the muscle placement can help conceal any issues with the implant. Saline implants, for example, have a tendency to ripple. If the implants are placed on top of the muscle and a woman doesn’t have a lot of breast tissue, it’s possible for the rippling to be visible beneath the skin.

Placing the implant beneath the muscle is also believed to lower the risk for capsular contracture, a deformity that occurs when too much scar tissue develops around the implant. Sub-muscular placement might also make mammograms easier to read.

Benefits of Over the Muscle Breast Implant Placement

One of the biggest benefits of the over the muscle or sub-glandular implant placement is that the surgery is usually a bit less invasive than the procedure required for under the muscle placement. Since the surgeon doesn’t have to cut down to or into the chest muscle, the surgery can take less time. Recovery afterwards might also be a bit shorter than the recovery after a sub-muscular placement.

Some women might prefer the results they get from an over the muscle implant placement. If you have a fair amount of natural breast tissue, you might not need the added camouflage of sub-muscular placement and you might be able to enjoy a natural look.

Often, over the muscle placement allows a surgeon to use larger implants than under the muscle placement. While the size of the implants depends in large part on a woman’s proportions and goals, women who want larger implants might be able to get them with sub-glandular placement but not with sub-muscular placement.

One last benefit of over the muscle placement is that the movement of the muscle doesn’t have much effect on the implant itself. When implants are put beneath the muscle, any flexing of the pectorals can alter the shape or the position of the implant. While the effect is temporary and goes away once the muscle is relaxed, it can be something that you want to avoid.

Implant Shape and Material Can Influence Placement

Along with the natural size of your breasts, the implant material and the size of the implant you choose can influence the ideal placement. For example, while traditional round implants can create an unnatural look if placed on top of the muscle, implants that have a tear drop shape mimic the natural shape and slope of the breasts and can look more natural, even if placed in the sub-glandular position.

As we mentioned above, saline implants are often better suited for under the muscle placement, thanks to their tendency to ripple. Silicone implants can go in either placement position, although their softer and smoother feel often makes them a better option for sub-glandular placement.

How to Choose the Best Implant Placement

Generally speaking, the less natural breast tissue you have, the more likely it will be that under the muscle implant placement will be the best option for you. For the most part, surgeons only recommend over the muscle placement to women have a considerable amount of existing breast tissue.

Along with determining the best material, the best size and the best shape for your implants, the placement of them is also something you and your plastic surgeon will discuss and decide on during your breast augmentation consultation. You might find that you go into the consultation expecting one type of placement and leave it having decided on the opposite.

To learn more about implant placement and breast augmentation in Houston, Texas, contact Dr. Paul Vitenas. Dr. Vitenas is one of the highest rated breast surgeons in Houston and in the country, and he performs hundreds of breast surgeries each year. To schedule your consultation, call 281-484-0088 today.