Breast Augmentation Decisions: Over or Under the Muscle?

Breast augmentation is without a doubt one of the most popular surgical cosmetic procedures for the past few years. Aside from an increasing number of breast implant options, the high satisfaction rate of women who underwent breast enhancement is another factor that is attributed to its popularity.

Subglandular vs. Submuscular Placement

When making the decision to undergo breast augmentation, implant placement is one of the important things to consider — should you have it placed over or under the chest muscle? By and large, the chest muscle plays two significant roles in breast augmentation: it provides added tissue coverage for women with less amount of breast tissue (hence a more natural look and feel) and it helps provide shape to the upper part of the breast.

Several factors have to be considered when deciding on the position of the implants such as your medical history, your body type, type of implant, size of implant, and the amount of breast tissue available. Although a personal consultation with an experienced plastic surgeon will help you decide the optimal placement for your implants, we have outlined the pros and cons of both subglandular and submuscular placement below.

When to Choose the Subglandular (Over the Muscle) Placement

Generally, we recommend an over-the-muscle implant placement if:

• you choose to have silicone implants (they are softer and does not require large amounts of tissue coverage)
• you choose saline implants and have a generous amount of existing breast tissue

The advantages of subglandular placement include the following:

• Natural looking outcomes with silicone implants
• Shorter recovery period and less painful recovery
• No implant distortion when the chest muscles are flexed

On the other hand, the subglandular placement has the following drawbacks:

• Implant may be more visible and palpable when saline implants are used
• Increased risk of rippling when using saline implants
• Increased risk of mammogram distortion which may require more views to be taken
• Increased risk of capsular contracture

When to Choose Submuscular (Under the Muscle) Placement

Generally, we recommend an under-the-muscle implant placement if:

• you choose to have saline implants
• small amounts of existing breast tissue
• strong family history of breast tumors/cancer

The advantages of submuscular placement include the following:

• Reduced risk of rippling when saline implants are used
• More natural look and feel when
• Less distortion during mammograms resulting to better imaging
• Decreased risk of capsular contracture
• Safer choice for those who might consider a breast lift in the future as it preserves the blood vessels that supply the nipples

Meanwhile, the drawbacks of submuscular placement include the following:

• Longer recovery period; more painful recovery
• Distortion occurs when the muscles are flexed
• Increased risk of “bottoming out”

Making the Decision

Let us help you make the decision! Get in touch with us by calling 858-633-7546 or fill out this contact form today to schedule a personal consultation with Dr. Chacon. We look forward to your visit!