Breast implant placement under the muscle or over the muscle is one of your biggest considerations if you are thinking about breast auugmentation. In addition to incision method, and breast implant size, many women struggle over this choice. There are advantages either way, which only makes the decision tougher!

Under the muscle placement is also referred to as submuscular placement. This method is now one of the most common locations in your body that your plastic surgeon will choose. Placement above the muscle, also known as subglandular placement, was far more common before the FDA withdrew the approval of silicone implants in 1991. As saline implants then rose in popularity, their relative risk of rippling forced to change in the medical profession towards using submuscular placement. Under the muscle placement is also thought to decrease the risk of capsular contracture, one of the risks in breast augmentation. It will be interesting to see if subglandular placement makes a comeback now that silicone implants have come back on the market since 2006.

You might think that submuscular placement means that the implant will be covered entirely under the muscle. Actually, only the upper 2/3rds of the implant is covered using this method. The bottom 1/3 is only covered by your natural breast tissue which, of course, can be quite thin. It is possible to get the implant to be covered entirely by muscle by positioning it high enough or by covering the lower half with fascia. In all likelihood, however, your plastic surgeon will probably be referring to a sort of partial submuscular placement. This position will also likely reduce the possibility of implant hardening.

Now that you know that the implant is not entirely covered by muscle, you will want to know about the issues this creates. The first thing to know is that the bottom third is only covered by the thinner tissue of the breast. This might make the rippling effect of saline to be visible in some patients, or perhaps even felt. This should be one of your pertinent factors in determining if saline or silicone is right for you. If you are concerned over the possibility of rippling, you may want to consider silicone breast implants.

What are the possible advantages of submuscular placement? Many surgeons will say that under the muscle placements are a bit easier to place. Additionally there is a reduced chance of implant visibility, especially with silicone implants. There is a lower chance of interference with a mammography as well.

The disadvantages are small really. For the doctor it might be difficult to master, but having done so will generally prefer it. As for the patient, there is more post-operative discomfort as you might expect due to stretching the muscle.

While the pain of breast augmentation is a large fear for many women considering breast augmentation, I would remind you that the pain is temporary. While the pain might be more with this type of placement, it will go away before you know it. To recover from submuscular breast augmentation is similar to recovering from a pulled muscle. The best way is to use it. Patients who use their muscles gently but regularly after the procedure will reduce their pain more quickly.

After the surgery, you will typically have drainage tubes in place for approximately two days while wearing a surgical bra. Stitches are used to close the incisions, and a bandage will be applied over your breasts to assist in healing and to reduce swelling. You will feel sore and tired for a few days after surgery, but most patients are up and around within two days after the procedure. Women are to refrain from strenuous upper body exercise for up to six weeks and lower body exercise for approximately three weeks.

Finally, one of the most important factors is that submuscular placement tends to result in a fuller breast. This is because the thickness of the muscle adds bulk and fullness. Is it worth the work and effort? For now you have something to consider. Be sure to discuss the advantages of submuscular and subglandular placements with your plastic surgeon before making your final decision.

With the rise of saline implants, under the muscle was clearly the best option for concealing the rippling effects. Most women today still choose under the muscle for a fuller looking breast.