Breast Implant Placement Under the Muscle or Over the Muscle

When considering breast augmentation, the breast implant can be placed under or over the pectoralis muscle. It is wise to inform oneself of the pros and cons of both options and discuss it with the cosmetic surgeon who will help in making a decision that suits the individual’s body and her lifestyle the most. Dr. Pasquale ensures that his patients understand the options and implications regarding implant placement and that they make an informed decision.

Most of the muscle beneath the breast tissue is the pectoralis major, which is similarly shaped as an oriental fan attached at the upper arm bone, the sternum or breast bone and at the ribs. This provides space for an implant to be set right behind the muscle.

Breast augmentation under the muscle

In this case the implants are mostly behind the muscle. The advantages of getting breast augmentation under the muscle is a more natural look and feel to the enlarged breast and a clearer mammography as compared to breast augmentation over the muscle. The implant edges are less visible and normally there is no rippling. The implant is held in place by the muscle itself so it tends not to sag with time as does the above the muscle placement.

Breast augmentation over the muscle

Placement of the breast implants in front of the muscle can lead to a quicker recovery with less pain and discomfort to the patient post operatively. This is due to the fact that the muscle tissue is left alone and only the fat and skin are cut to place the breast implant. Muscle stretching is what causes pain. If you have minimal breast tissue, over the muscle can lead a higher chance of visual rippling. The chance of rippling may be lessened by the usage of gel / silicone implants or a high profile shape. Some surgeons believe that a woman with ptosis or sagging of the breasts and sufficient breast tissue should have over the muscle placement of the implants. Others believe this leads to more sagging as the skin stretches over time and that a breast lift is required in addition to the breast augmentation as a long term fix. Over the muscle placement can also interfere more so with a mammography as it makes it difficult to get a complete image.

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Authored by: Michael Pasquale