Under The Muscle versus Above The Muscle Implants

Published on January 31, 2020

One of the most frequently asked questions patients have when they consider getting breast implants is whether to place the implant under the muscle or above the muscle. Many patients feel there is one correct answer, but that’s not necessarily true. By consulting with a board-certified plastic surgeon, you will get an expert opinion on which implant placement will give you the results that are best for your body and lifestyle.

There are many factors to consider when deciding where to place breast implants. Breast augmentation is a very individualized surgery. It is crucial to have a plastic surgeon that will take their time to understand your goals and explain the different implant options. Every patient is different, but a good doctor will go over the best size and the best implant position to achieve the results you want.

Breast implants under the muscle are also referred to as submuscular or dual-plane implants. One of the most significant advantages of this placement is that it reduces the chances of developing capsular contracture. Capsular contracture is when the capsule tissue around the breast implant becomes tight or very firm. This condition can make the breast look unnatural and be painful. Under the muscle implants also provide a more natural breast contour, particularly in patients who don’t have a lot of breast tissue or have thin breast skin.

Silicone and saline breast implants can both be placed under the muscle. Today, most people choose silicone implants. For patiemts that have thin breast tissue, putting silicone implants under the muscle is best. Saline-filled implants are typically placed under the muscle for additional support and contouring. Another advantage of placing implants under the muscle is that it reduced the risk of rippling. Breast implant rippling typically occurs when there is not enough natural breast tissue covering an implant, creating folds or wrinkles that are visible through the skin.


Implants placed over the muscle are known as sub-glandular or subfascial implants. In this approach, the implant is placed above the pectoral muscle and below the breast tissue. The advantages of over the muscle implants are there’s no risk of distortion by the muscle movement. This placement is usually best for women involved in competitive bodybuilding and other sports that require a lot of chest workouts. (Heavy chest workouts can cause the pectoral muscles to push the implants out of place if the implants are under the muscle.) The recovery for implants over the muscle is shorter and less painful than implants placed under the muscle.

While there is no right or wrong answer, most women prefer the dual-plane or sub-muscular implant placement. The best way to make the best decision is to schedule a personal consultation with one of our award-winning, board-certified plastic surgeons, Dr. Peter Butler, Dr. Jocelyn Leveque, and Dr. Nathan Patterson.

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