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Breast Augmentation: Under or Over the Muscle?

Dr. Richard Arabitg • May 11, 2020
There are many factors to consider when thinking about undergoing breast augmentation. Some of the most important of course being implant size, incision placement and if it is the right procedure for you. One of the other factors that many do not think about until they go to their consultation is whether or not they should have their implants placed over or under the muscle. 

Many individuals who look into undergoing breast enhancements do not realize that this question is a fundamental one in the overall look and goals they would like to achieve. Each option has its own benefits and risks, and of course, it always comes down to what the individual patients expected outcomes are. 

Over the muscle implants, also known as sub-glandular placement, has the ability to withstand larger implants. The soft tissue and skin allow for more stretching over a larger choice implant than a muscle does. This also allows for a more predictable result of how the breast will eventually settle. The skin and tissue will mold more accurately to the outline of the implant. The pain from surgery has been reportedly less strenuous with above the muscle, since the procedure is less invasive (and can even be done through an incision in the belly button) and no muscles have to be displaced. There is also a lower risk of the implant becoming injured or losing strength. 

Each patient will heal in a different way and with that sometimes hardening of the soft tissue due to stretching can cause capsular contracture. This is when the tissue around the implant can become harder and puckered similar to a scar. Another issue some over the muscle patients experience is known as “rippling”. This is when a patient may have thinner soft tissue to cover the implant and create a rippling effect on the lateral surfaces of the breast. Women may experience this is they have a smaller amount of natural breast tissue in relation to the size of implant they would like. Your surgeon will know what sizes are more likely to show this and discuss with you options during your consultation. 

Under the muscle implants, or submuscular placement, are more common in patients with smaller breasts who are seeking a more natural appearance of breast augmentation. When there is more of the natural tissue covering the implant, this effect is created. Having submuscular placement also helps to receive a more accurate mammogram than over the muscle implants. If having accurate readings from mammograms is something you are concerned about later on, make sure to talk with your doctor during your breast augmentation consultation. Submuscular implants are also known to reduce the risk of getting capsular contracture which over the implants seem to develop. Although each patient is different, and the risk of painful capsular contracture is still there, under the muscle seems to cause less deformities. Under the muscle implants are less likely to move around, creating a displaced, or even evident of a breast implant, look with more muscle to keep if weighed down and in place. 

Whichever route you decide is best for your breast augmentation in Orlando Florida, make sure to consult with the expert team at Plastic Surgery Central Florida. 


11 Apr, 2024
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