Breast Implant Placement: Is Above or Below the Muscle Better?

The Best Breast Implant Placement Depends on Many Factors

In addition to choosing the size, shape (round or tear drop), material (silicone or saline), and profile (height) of your breast implants, the “placement” of your implants must be considered. Your breast implants may be placed over, under or between the muscles in your chest.

Choosing the right placement is an important decision made by your breast augmentation surgeon, based upon many factors including the type of implant, the increase in size from your current breasts, the amount of available breast tissue, the condition and amount of skin, your size, your lifestyle, and your appearance goals.

Top Troy, MI area plastic surgeon Dr. Ali has helped thousands of women achieve the look and feel they desire with perfectly chosen and expertly “placed” breast implants. In this article we explain the three types of breast implant placement.

Breast Structure & Breast Implant Placement

If you look at the image below you can see that natural breasts are tear-drop shaped, with milk-producing glands that sit below the nipple and above two sets of pectoral muscles that hold everything in place. The rest of the breast is “filled” with a system of fatty tissue (“adipose”) and ligaments that support and protect the structure of the breast.

The size and shape of each woman’s breasts are primarily determined by her hereditary. But other factors can affect breast size including: gaining or losing weight, medications, pregnancy, nursing, hormonal changes, menstruation, menopause. Traumas, injuries, accidents, and diseases such as cancer can also affect breast size and shape.

In this article, we will explore the differences between three common types of breast implant placement: subglandular, subpectoral, and submuscular, along with their applications and advantages.

Three Types of Breast Implant Placement

One of the most important factors in achieving a successful breast implant is selecting the proper placement of the implant. Breast implants can be placed three different ways inside of the woman’s breasts: subglandular, subpectoral, and submuscular.

Choosing the right breast implant placement is a critical aspect of breast augmentation surgery. Dr. Ali, a top board-certified plastic surgeon serving the Troy, MI area, understands the importance of tailoring surgical techniques to each patient’s unique anatomy and goals.

1. Subglandular Breast Implant Placement

Subglandular placement puts the breast implant directly behind the mammary gland, but in front of all the muscle. Subglandular breast implant placement involves the least complicated surgery, and has the quickest recovery time.

The disadvantages of subglandular breast implant placement includes a slightly increased chance for capsular contracture. Subglandular breast implant placement also means that the implant has less “protection” over it and is also more “visible” under the skin. So, in some cases, if a woman does not have sufficient available breast tissue, the implant may be seen “rippling” through the skin, and/or the implant may be at slightly higher risk of damage.

Subglandular breast implant placement is most suitable for patients with adequate breast tissue and minimal sagging (ptosis). And it is deal for individuals seeking enhanced cleavage and a more prominent appearance.

Advantages of subglandular breast implant placement include a shorter recovery period and less postoperative discomfort compared to submuscular placement. Additionally, it may produce a more natural movement of the breast implant, particularly in athletic individuals. Also, subglandular breast implant placement is often a good option for athletic women, because it prevents well developed chest muscles from interfering with the look of the implant.

Additionally, there is less interference with chest muscle activity, potentially reducing the risk of animation deformity (implant distortion with muscle contraction).

2. Subpectoral Breast Implant Placement

Subpectoral breast implant placement involves positioning the implant under the pectoralis major muscle. But because of the structure of this muscle (see image below), the implant is only partially covered.

This implant placement is preferred for patients with thin breast tissue or mild to moderate ptosis. This method provides additional tissue coverage, especially in patients with minimal natural breast tissue. So, it is a common choice for individuals seeking a more natural-looking outcome with reduced risk of visible implant edges or rippling.

Advantages of subpectoral breast implant placement include offering improved long-term implant support and stability, reducing the risk of implant displacement or bottoming out.
It may also result in a lower risk of capsular contracture (scar tissue formation around the implant) compared to subglandular placement.

But while subpectoral breast implant placement reduces the risk of capsular contracture, and also minimizes any visible implant rippling, the disadvantage is that recovery time from subpectoral breast implant placement is typically longer – and somewhat more painful. This is because the plastic surgeon must manipulate the muscle during surgery. Subpectoral breast implants may also take longer to drop into their natural position after surgery.

Additionally, subpectoral breast implant placement is not a good remedy for lifting sagging breasts- because the implant is only partially covered by the muscle. So the weight of the fluid is not supported, and the implant may droop and/or create bulges.

3. Submuscular Breast Implant Placement

Submuscular breast implant placement positions the implant firmly and completely behind the chest muscle wall. A submuscular breast implant is placed behind the pectoralis major muscle and behind all of the supporting connective tissue (“fascia”) and non-pectoral muscle groups. For this reason they are a better option for women with drooping breasts.

Submuscular breast implants also tend to be the best for mammograms, because the breast implant is completely behind the areas that needs to be examined. This can offer an advantage to women with a family history or other risk factors for breast cancer – since their mammograms will not be impacted by the breast implants at all.

Submuscular placement is recommended for patients with thin skin, limited breast tissue, or a desire for a more conservative breast augmentation. And it is a very common choice by plastic surgeons for breast reconstruction following mastectomy or congenital deformities.

Another advantage of placement completely under the muscle is that it provides maximum coverage and camouflage of the implant, minimizing the risk of visible rippling or palpability. Additionally it offers enhanced long-term stability and support, particularly in patients with significant ptosis or laxity. There is also the potential for a lower risk of capsular contracture and implant malposition due to improved soft tissue coverage and blood supply.

The disadvantages of submuscular breast implant placement is that there is an even longer – and somewhat more painful – recovery period, because the surgeon must manipulate even more breast muscle and ligaments.

breast implant troy

Top Breast Implant Surgeon | Troy, MI Area

The choice of breast implant placement is a crucial decision that should be made by a highly experienced plastic surgeon like Dr. Ali in the Troy, MI area. Understanding the differences between subglandular, subpectoral, and submuscular placement, along with their respective applications and advantages, allows patients to make informed decisions with their plastic surgeon aligned with their aesthetic goals and anatomical considerations. Dr. Ali’s expertise and personalized approach ensure optimal outcomes tailored to each patient’s unique needs and preferences.

Dr. Ali is a board certified Troy area plastic surgeon who has performed breast implants on thousands of women in Birmingham, Rochester Hills, West Bloomfield, and Troy, MI area. Dr. Ali will be happy to offer you a consultation to answer all of your questions, and help you choose the best breast implant size, shape, material and position for your body type and appearance goals.

Feel beautiful inside and out, with breast implant surgery. And remember, financing options are also available.