Breast Augmentation: Implant Under Muscle vs Over?
Breast Augmentation: Implant Under Muscle vs Over?
Choosing to get breast implants is a personal decision—but how they’re placed during surgery is just as important as what size or shape you choose. The two most common placement options are:
Under the muscle (submuscular)
Over the muscle (subglandular)
Each technique has benefits and drawbacks depending on your anatomy, lifestyle, and cosmetic goals. At Stratus Plastic Surgery, we guide patients through this decision so they can feel confident and informed.
Let’s break it down.
What Does “Under the Muscle” Mean?
In submuscular placement, the implant is positioned beneath the pectoralis major muscle, which lies between your chest wall and breast tissue.
Pros of Under-the-Muscle Implants:
More natural slope and appearance, especially for thin patients
Lower risk of visible rippling
May reduce risk of capsular contracture (scar tissue tightening)
Can offer clearer mammogram results
Cons:
Longer initial recovery period
Temporary animation deformity—movement of the implant when flexing chest muscles
Slightly more discomfort post-surgery
This method is ideal for women with minimal natural breast tissue who want subtle, natural-looking results.
What Does “Over the Muscle” Mean?
In subglandular placement, the implant is positioned on top of the muscle, directly behind the breast tissue.
Pros of Over-the-Muscle Implants:
Easier recovery and less initial discomfort
No implant distortion when flexing chest muscles
Can be ideal for athletes or bodybuilders
Cons:
Higher risk of visible rippling, especially in thinner patients
More detectable implant edges
Slightly increased risk of capsular contracture
Can interfere more with mammogram imaging
If you have adequate breast tissue and want more upper-pole fullness, this method may suit your goals. Some patients even choose to pair implants with fat transfer for enhanced contouring.
Under vs Over the Muscle: Side-by-Side Comparison
| Factor | Under the Muscle | Over the Muscle |
|---|---|---|
| Natural Look | Excellent for lean patients | May look rounder or more artificial |
| Recovery Time | Longer | Shorter |
| Pain Level | Slightly higher | Lower |
| Risk of Rippling | Lower | Higher |
| Implant Movement | More stable | Possible shifting |
| Best For | Thin patients, natural look | Active patients, adequate tissue |
| Activity Concerns | May show animation during workouts | No animation issues |
Which Option Looks More Natural?
For most women with less natural breast tissue, implants placed under the muscle tend to look more natural. The muscle provides an extra layer of coverage, giving a gentle slope and hiding any visible edges.
However, if your goal is a more prominent or structured look, over-the-muscle placement may better match your aesthetic preferences.
Does Implant Placement Affect Recovery?
Yes. With under-the-muscle implants, recovery may involve more soreness and tightness, especially in the first week. But long-term comfort and appearance often outweigh the short-term inconvenience.
Over-the-muscle placement generally allows for quicker mobility and less pain—but may sacrifice subtlety and natural contour in leaner patients.
You can read more about what to expect during breast augmentation recovery here.
Can Placement Affect Long-Term Results?
Absolutely. Placement can affect how the implants settle over time, how they respond to weight fluctuations, and whether they shift or remain in place.
Additionally, an under-the-muscle breast augmentation tends to age more gracefully, especially in terms of skin stretching and sagging. Over-the-muscle implants can become more visible over time as the breast tissue thins.
What’s Right for You?
There’s no one-size-fits-all answer. At Stratus Plastic Surgery, Dr. Haruko Okada will consider:
Your body type and existing breast tissue
Your activity level (especially if you’re an athlete)
Your desired aesthetic outcome
Your skin quality and long-term goals
In some cases, a breast lift may be recommended alongside augmentation for the best shape and position.
Let’s Find Your Best Fit
Whether you want a subtle boost or a dramatic change, your implant placement should enhance your body and your goals. At Stratus Plastic Surgery, we tailor every breast augmentation to achieve proportional, personalized, and natural-looking results.
Ready to take the next step? Schedule your consultation and let’s create the ideal plan for your breast augmentation.