Key Takeaways
- The decision to place breast implants over or under the chest muscle depends primarily on the amount of natural breast tissue a patient has at the top of the breast.
- Over-the-muscle (sub-glandular) placement is easier to perform, requires less recovery time, and can create a more dramatic, rounded upper pole appearance.
- Under-the-muscle (sub-muscular) placement produces a more natural-looking result, reduces rippling visibility, and has a lower rate of capsular contracture.
- Patients with insufficient tissue at the top of the breast are better served by under-the-muscle placement to prevent the implant outline from showing through the skin.
- Your board-certified plastic surgeon evaluates your individual anatomy during consultation to recommend the placement that will achieve the most natural and proportional result.
There are several decisions to make when you decide to get breast implants in Northern Va. After much discussion and consultation with your surgeon, you will decide whether silicone or saline breast implants are best for you. You will decide what kind of incisions the surgeon will make. You will also need to decide if you want the implants placed over or under the muscle in the breast.
One of the major deciding factors in where the place the implant will be the state of your existing breast tissue at the top of the breast, closer to the collarbone. If the tissue at the top of the breast is too thin, the outline of the implant will be clearly visible if you place it over the muscle. However, if there is sufficient tissue to hide the implant outline, you can place it over the muscle.
Over-the-muscle implants are easier to place in the breast, and the surgery requires less recovery time (since the muscle tissue is not disturbed). This placement creates a more rounded look with more obvious cleavage. You can also use larger implants with this placement than you would with under-the-muscle placement.
On the other hand, there is nothing supporting an over-the-muscle implant other than fat, breast tissue, and skin. This placement has an increased risk of the implants bottoming out, or sliding down out of place. There is also an increased risk of visible rippling of the implants. Additionally, some women dont like the rounded look of this placement because they find it less natural looking.
Patients can also elect to have an implant placed partially under the muscle, where the bottom portion of the breast implant is supported by skin but the top portion is behind the muscle. This gives the implant a more rounded look and is easier to place than a complete under the muscle placement, but it still has a great risk of bottoming out.
An implant that is totally under-the-muscle is behind the pectorals on the top 2/3, and is supported by connective tissue on the bottom portion. This placement has the most natural appearance and the smallest risk of bottoming out or having visible rippling. It also provides for better mammography visibility. However, this surgery results in the most discomfort post-op, is the most difficult to perform, and the breasts may be a bit higher than normal until the muscles adapt.
No one breast implant placement is right for every patient. You will need to discuss your options in depth with your surgeon, so he can help you select the placement that will give you the desired results. Visit our breast augmentation page for comprehensive educational information, patient testimonials and more on the procedure.
For more information about breast implants in Northern Va, call us at (703) 574-2588 or click here to set up a consultation.
Frequently Asked Questions
What is the difference between over-the-muscle and under-the-muscle implant placement?
Over-the-muscle (sub-glandular) placement positions the implant between the breast tissue and the chest muscle, while under-the-muscle (sub-muscular) placement positions it beneath the pectoral muscle. Each placement has distinct aesthetic characteristics, recovery profiles, and complication risk profiles that your surgeon will discuss with you.
What are the advantages of under-the-muscle implant placement?
Sub-muscular placement produces a more natural-looking result, reduces the visibility of implant rippling in patients with thin breast tissue, has a lower association with capsular contracture, and makes mammography interpretation easier. It is the more commonly recommended placement for patients with limited natural breast tissue.
What are the advantages of over-the-muscle placement?
Sub-glandular placement involves a less invasive procedure with a shorter recovery period since the pectoral muscle is not disturbed. It can create a more dramatically full upper pole appearance that some patients prefer, and may be a better option for very athletic patients who want to minimize disruption to their chest muscle function.
How does a surgeon decide which placement is right for a patient?
The key factor is the amount of natural breast tissue covering the top of the breast. If there is sufficient tissue to hide the implant outline and edge, over-the-muscle placement can work well. If tissue is thin in that area, the implant may be visible unless placed beneath the muscle. Your surgeon will assess your specific anatomy during consultation.
Does implant placement affect recovery time?
Yes. Patients with under-the-muscle placement generally experience a longer and somewhat more uncomfortable recovery because the pectoral muscle must stretch and adjust to accommodate the implant. Most patients return to normal activities within two to three weeks, compared to a somewhat faster timeline for sub-glandular placement.