Breast Implants Under Muscle or Over: Which is Right for You?

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Patients have two choices when it comes to placement of their breast implants: under or over the muscle. Implants that are placed under the muscle are under the pectoral chest muscles. Those placed over these muscles are inserted between the muscles and the breast glands. The medical terms for these types of implementations are submuscular or subglandular. Your body shape and preference to post-surgical appearance will influence the type of implant technique used.

breast implants

Subglandular Implants

When the use of silicone implants were in the majority of breast augmentation surgeries, the general insertion was over the muscle. Some surgeons prefer to place implants under the muscle for medical reasons. These surgeons assert that implants placed under the muscle allow for better mammogram visuals. With the risk of breast cancer very high for many women, regular mammogram screenings are important. Mammograms are still possible with subgladular implants but may be a little more uncomfortable.

Subglandular implants are typically best for women that have lost breast tissue volume, but not skin volume. This gives what is called an ‘empty bag’ look. Implants placed over the muscle can fill this and give the women a more natural, younger look.


As noted above, submuscular implants are best when it comes to MRI or mammograms. Some women prefer these types of insertions over subgladndular due to the more natural look and feel. Silicone has been noted to give a softer feel which can make over the muscle implantation work well. The exceptions to this is when the patient is very thin. Patients with very little body fat benefit from the placement of implants, no matter what type, under the muscle. This also reduces the risk of rippling or dimpling over or around the implant as the muscle gives a little extra padding.

Silicone implants that have a rough texture should be placed under the muscle. If this is not done then the texture can cause rippling or dimpling. There is also a reduced risk of encapsulation when the implant is submuscular. The name submuscular is actually a misnomer as the implant is not placed fully under the pectoral muscle. Only the top portion of the implant is inserted under the muscle while the bottom is subglandular or submammary. Women with very little body fat may have trouble concealing their implants on the sides or top portion of the breasts no matter how their implants are placed. This is because all implants will have some portion protruding from the muscle.

Patients may need to have their breast implants replaced or moved after they have physically aged. Gravity plays havoc on all bodies. This pulling, plus aging, has a thinning effect on the skin. All women with implants have a possibility of seeing rippling or dimpling due to the aging process. This typically has nothing to do with the surgeon or implant and the only answer is to undergo another procedure. Most women will not need to do this for many years.