Breast Implant Placement 101

Breast augmentation surgery may be a surefire way to get the breasts you ultimately desire, but when it comes to making decisions, there are a variety of factors to take into consideration. A properly trained board-certified plastic surgeon should be able to guide you through your decision-making process. One of those decisions will be if your implants should go over or under the muscle. So, what’ the difference?

Subglandular: Over the Muscle
The upside: Since the implant is placed over the pectoral muscle and below the breast tissue, recovery time is usually shorter because there is fewer traumas to the underlying tissues. Placing the implant over the muscle can also give a slightly lifted look.

The downside: The implant sits closer to the surface of the skin, making it more detectable through touch and more visible if your skin is thin. In a mammogram, additional views may be necessary.

“Silicone implants allow for more patients to have their implant placed subglandularly (in front of the muscle) because there is less rippling and visibility with silicone,” explains Washington, DC, plastic surgeon Scott Spear, MD.

Submuscular: Under The Muscle
The upside: Positioning the implant below both the pectoral muscle and the breast tissue allows for the implant to be less visible and act as an internal bra, keeping the implant in place. The implant is also only partially covered by muscle, so it’s less likely to cause problems with mammograms.

The downside: It’s a more painful recovery because the internal anatomy of the tissue behind the breast is hanged more.

Placing the implant under the muscle is good for those who are thin because it provides extra coverage over the implant, which gives a more natural look.


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  • Richard Rand MD
    Posted on

    In most all instances, below the muscle placement is better because the implants are better hidden under more tissue, they retain upper pole fullness better, and mammograms are easier and potentially more accurate.

  • Dr Rhys Branman
    Posted on

    All of the above is correct and keep this in mind too. If your implant was placed above the pectoral muscle part of your breast tissue will be obscured during a mammogram. The breast tissue will not be quite as obscured if your implant was placed beneath the pectoral muscle. An implant can hide 15 percent to more than 50 percent of breast tissue. This is why it is important for you to inform the mammography clinic ahead of time that you have had breast augmentation. However, in either case it is still important to inform the people performing the mammography of your implants. Specially trained mammographers know how to x-ray the breast after implantation using special implant displacement views. The procedure requires 4 extra pictures (2 on each breast), and the breast must be pulled forward and the implant pressed back as much as possible against the wall of the chest. The radiologist must also read the mammogram with the implant in mind. But don't worry! Mammograms work with breast implants too. Dr Rhys Branman Little Rock Cosmetic Surgery Center

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