Breast Implant Position Part II

"Over the Muscle" Breast Augmentation, a Blog by Dr. Loftus

Placing the breast implants over the muscle is also called subglandular or submammary because the implant is directly beneath the glandular tissue of the breast . Positioning the implant over the muscle leads to a faster recovery. There is less pain and swelling. Also, the shape of the breast can be improved easily because the implant is in direct contact with the breast tissue which is draped over it. Sometimes plastic surgeons describe this as the implant "molding" the shape of the breast. This is not entirely accurate. The interaction between the implant and breast tissue results in the final shape. This change is variable. However, in most patients this can help improve the shape of the breast. The improvement results from the increase in volume filling the skin and the shaping effect that the implant has on the breast tissue. The breast implant can exert this effect best in a subglandular (over the muscle) augmentation because it is in direct contact with the breast tissue. This effect is not as pronounced with the implant positioned under the muscle.

Over the Muscle Breast Augmentation Disadvantages

The down side of placing the implant over the muscle is that you may see and feel more of the implant than you would like. Think of it this way. The more of you (your breast tissue) that covers an implant, the less you feel the implant and the more you feel your own tissues. Your breast will feel more natural and look more natural the more of you that covers the implant. If there is less breast tissue covering the implant you are more likely to see breast implant rippling, and you will feel the implant more when you touch your breasts. Another disadvantage is that there is a higher rate of capsular contracture when the implant is placed over the muscle. Finally, there is more interference with mammography when the implant is over the muscle.

So who benefits from placing a breast implant over the muscle? Classically, it is women with ample breast tissue where there is enough soft tissue coverage to minimize the risk of rippling and implant visibility. You’re probably thinking, "If I had ample breast tissue I wouldn’t need a breast augmentation in the first place." We completely understand if you feel that way. Most women seeking breast augmentation do not have much breast tissue and definitely fare better with the implant placed under the muscle.