Breast Implant Placement — Over vs Under the Muscle

Where the implant is placed relative to the chest muscle (pectoralis major) is one of the most technically significant decisions in augmentation. Placement affects appearance, feel, recovery, and long-term outcomes in distinct ways.

Subglandular Placement — Over the Muscle

Subglandular placement positions the implant between the breast tissue and the pectoralis major muscle. This tends to create a more projected, rounded appearance, particularly in the upper pole. Recovery is typically faster and less painful. However, patients with less natural breast tissue may experience more visible rippling, and mammogram screening can be more complex.

Best for: Patients with adequate natural breast tissue, those wanting faster recovery, and patients who exercise heavily and want to avoid animation deformity.

Submuscular Placement — Under the Muscle

Submuscular placement positions the implant beneath the pectoralis major. This provides additional tissue coverage, reduces rippling, and creates a more natural slope at the upper pole. The primary downsides are a longer, more painful recovery and 'animation deformity' — visible movement of the implant when the chest muscle is flexed during push-ups, heavy lifting, or chest exercises.

Best for: Patients with minimal natural breast tissue and those prioritizing a natural-looking upper pole slope.

Dual-Plane — The Most Common Modern Technique

Dual-plane is a hybrid approach and is now the most commonly used technique. The implant is positioned partially under the muscle (upper portion) and partially under the breast tissue (lower portion). This combines the natural upper pole slope of submuscular placement with reduced animation distortion in the lower pole. Well-suited to a wide range of patients.