Which Looks More Natural: Breast Implants Over or Under the Muscle?

When it comes to breast augmentation, there are several decisions that contribute to the final results. From implant size to incision location, there’s no doubt the process can be overwhelming without the right guidance. Our experienced plastic surgeon, Dr. Scott Miller, is committed to helping patients understand how each decision can affect their outcome. One question that many patients have, however, is whether to get their implants over or under their muscle.

Better is Better
While each option can offer beautiful results for the right individual, Dr. Miller must assess each individual to determine which implant placement can potentially help them achieve the most natural look. For most women, placing the implant partially underneath the chest muscle wall offers a more natural contour. Other advantages of partial submuscular placement (also known as partial retropectoral placement or dual plane augmentation) include a more natural feel (there is more you between the world and the implant), less chance of hardening of the capsule (better blood supply and constant muscle “massage” of the implants), better preservation of nipple sensation (the nerve runs above/superficial to the muscle), and the ability of mammograms to visualize the breast tissue more fully. Dr. Miller especially recommends this route to those with little to no breast tissue because the extra layer of tissue can provide a more subtle slope to the breast curve, while also disguising implant appearance.

Never Say Never
For patients with adequate breast tissue, thicker skin and particularly if a subglandular implant is already in place, Dr. Miller may suggest leaving the breast implants over the muscle. A benefit to this approach is the recovery is typically shorter and more comfortable, since the muscle does not undergo the additional trauma. For over-the-muscle placement, Dr. Miller definitely recommends silicone implants, as there is less risk of rippling, like that of saline-filled implants.

Since there is no objective way of knowing what will look the best and most natural, Dr. Miller encourages patients to seek a board-certified plastic surgeon who is highly experienced in breast augmentation.

For more information about your implant options, or to schedule your consultation with Dr. Miller, please contact us today.