How to Choose Implant Placement: Over or Under Muscle?

When contemplating breast augmentation surgery, choosing the ideal implant placement—over the muscle (subglandular) or under the muscle (submuscular)—is a critical decision. Your choice will significantly impact the outcome of your surgery, including the appearance and longevity of your breast implants. To ensure you're satisfied with your results, let's delve into the details of this decision-making process.

1. Body Type and Existing Breast Tissue

Understanding your body type and the amount of existing breast tissue is fundamental in making the right implant placement choice. Here's a more in-depth look:

• Over the Muscle (Subglandular): This placement is often suitable for individuals with sufficient natural breast tissue and a desire for more projection. It allows for the implant to be positioned directly behind the breast tissue, providing ample coverage and support. Women with good breast tissue typically experience a more natural-looking result with this placement.
• Under the Muscle (Submuscular): If you have minimal natural breast tissue or are slender, placing the implants under the muscle can offer several advantages. The muscle provides an additional layer of coverage and helps hide the edges of the implants. This is especially beneficial for those concerned about visible rippling or wrinkling. Submuscular placement can create a smoother and more natural appearance in such cases.

2. Aesthetic Goals

Your aesthetic goals play a significant role in determining implant placement. Consider the following:

• Over the Muscle: If you desire a more augmented, "round" appearance with pronounced cleavage, placing the implants over the muscle may be preferable. This placement allows for greater projection and can create a fuller look in the upper portion of the breast.
• Under the Muscle: For those seeking a subtler, more natural-looking result, submuscular placement can achieve a softer contour. The muscle acts as an additional layer, resulting in a gentle slope and a reduced risk of an overly artificial appearance.

3. Risk of Complications

Understanding the potential complications associated with each placement option is crucial:

• Over the Muscle: While over-the-muscle implants can yield beautiful results, they may be more prone to visible rippling or implant visibility, especially in individuals with thinner tissue. This is an important consideration when deciding if this placement is right for you.
• Under the Muscle: Submuscular placement can reduce the risk of implant visibility and rippling. However, it may come with a slightly longer recovery period and potential discomfort due to muscle involvement. Discuss these potential trade-offs with your surgeon during the consultation.

4. Lifestyle and Physical Activity

Your lifestyle and physical activity level should also factor into your decision:

• Over the Muscle: This placement may be more comfortable for individuals with less physically demanding routines. It can be a suitable choice for those who don't engage in rigorous exercise or heavy lifting.
• Under the Muscle: If you lead an active lifestyle or are involved in activities that require chest muscle engagement, submuscular placement may be more appropriate. The muscle provides additional support and helps reduce the risk of implant displacement during physical activities.

5. Consultation with a Surgeon

Ultimately, the most crucial step in determining the optimal implant placement is a consultation with a board-certified plastic surgeon. They will conduct a thorough assessment of your unique anatomy, listen to your goals, and provide expert guidance based on their experience and expertise.

During your consultation, don't hesitate to ask questions and express your concerns. Your surgeon will explain the advantages and disadvantages of each option in detail, tailoring their recommendations to your specific needs and objectives.

Selecting the right implant placement—whether over or under the muscle—is a decision that warrants careful consideration. Your body type, aesthetic goals, lifestyle, and the guidance of a qualified surgeon all play vital roles in making the best choice for your breast augmentation surgery.