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Breast Augmentation: Over the Muscle or Under the Muscle?

Posted November 03, 2020 in Breast Augmentation

During breast augmentation, your plastic surgeon can insert your breast implants either over your chest muscle or under it. The placement location of the implants will ultimately affect the shape, appearance, and feel of the breasts after breast augmentation. While either placement can be used, Dr. Taleisnik recommends under-the-muscle placement for most patients. This technique has the least long-term risks and usually produces the most attractive and natural-looking results.

Over-the-Muscle Breast Implant Placement

If desired, your surgeon can insert your breast implants over (in front of) the chest muscle. This is sometimes called subglandular or submammary placement, or more commonly, over-the-muscle implant placement. The implants will rest directly next to the breast tissue rather than beneath the breast, creating a more rounded look.

Pros of Over-the-Muscle Placement

Over-the-muscle placement tends to have a shorter recovery because the surgery causes less trauma to the breast tissues. It can create a more lifted appearance without the surgeon incorporating any breast lift techniques. This technique may also be helpful in correcting certain breast shape problems.

Cons of Over-the-Muscle Placement

There are several important cons of over-the-muscle implant placement. Inserting the implants above the muscle often results in less natural-looking results than under-the-muscle implant placement. Because the implants are directly beneath the breast tissue, they appear to push the breast outward more and create a more unnaturally rounded appearance. Additionally, over-the-muscle implant placement can interfere with later mammography. Lastly, placement of the implants over the muscle is associated with a higher risk of both capsular contracture and bottoming out, where the implant can shift out of position. These issues can only be corrected with an additional breast revision surgery.

Under-the-Muscle Breast Implant Placement

Instead of placing the breast implants over the chest muscle, your surgeon can insert your implants underneath (behind) the chest muscle. The is sometimes called subpectoral or submuscular placement, or more commonly, under-the-muscle implant placement. The implants are padded by the chest muscle and typically have better long-term support, as well as a more natural look and feel.

Pros of Under-the-Muscle Placement

Inserting the implants below the chest muscle allows the muscle fascia to hold the implants more in place. This reduces the risk of bottoming out because there is greater tissue support for the implants. It also results in a more natural look and feel; instead of looking as though you had breast augmentation, it will simply appear as though you have naturally larger breasts. Moreover, this technique has a significantly lower risk of interference with mammograms as well as reduced risks of capsular contracture, bottoming-out, rippling, and damage to the breast ducts.

Cons of Under-the-Muscle Placement

There are two downsides to under-the-muscle placement. The first is that it is a more difficult procedure and requires more surgical skill, which means that fewer surgeons can perform this technique well. Secondly, because it causes more tissue trauma, this implant placement has a more difficult recovery. However, even with under-the-muscle placement, patients usually feel ready to return to work within just 5 to 7 days.

Why Under-the-Muscle Implant Placement is Usually Best

Under-the-muscle breast implant placement is Dr. Taleisnik’s preferred choice for most breast augmentation patients. As a skilled and experienced surgeon, he has performed countless breast enhancement surgeries with under-the-muscle placement. Placing the implants under the pectoral muscle is associated with significantly fewer long-term risks, which means your risk of needing corrective breast revision surgery to correct complications is lower. Furthermore, even though the recovery is slightly more difficult with this technique, the resulting appearance can be remarkably more natural and may have a more lasting positive impact on how you and those in your social circles see you.

Dr. Andres Taleisnik is a board-certified plastic surgeon with extensive experience performing breast enhancement surgeries. He has worked with countless patients who have had a wide variety of preferences and needs, and he knows how to achieve the best results for each individual patient. Call (657) 294-8375 or contact us online to schedule your consultation with Dr. Taleisnik today.