One of the most frequently asked questions by patients considering breast augmentation is: “Should the implant be placed above or below the muscle?” Implant placement in breast augmentation is a surgical technique; therefore, there is no single answer to this question. Both techniques have their own advantages, limitations, and suitability criteria for different patient profiles. The surgeon determines the most appropriate option based on the patient's anatomy, body structure, lifestyle, and expectations. For this reason, it is important to explain implant placement techniques in a clear, understandable, and medically accurate manner.
In the following sections, we explain the differences between these two methods, their recovery processes, their effects on natural appearance, their suitability for patients who exercise, and how the implants behave over time.
Breast augmentation placement
There are different techniques for placing implants in breast augmentation surgery. Here, we will discuss subglandular and submuscular placement.
Over-the-muscle (Subglandular) implant placement
Breast implants are placed immediately behind the breast tissue and in front of the chest muscle (pectoralis major). No incision is made on the muscle during this procedure, which makes the procedure less invasive. Recovery is faster, and the patient returns to their daily activities in a short time. In addition, the chest muscle does not interfere with the placement of the implant. This keeps the implant stable under the breast and helps prevent it from shifting.
Since the implant is placed on top of the chest muscle, the upper chest appears fuller and rounder. If the patient's breast tissue is thin or has thinned over the years, the implant may become noticeable. Patients must be suitable for implant placement on top of the chest muscle, meaning they must have at least enough breast tissue to cover the implant.
Under-the-muscle (Submuscular) implant placement
Breast implant is placed in the space between the chest muscle and the ribs. The muscle tissue partially or completely covers the implant. This placement requires an incision in the chest muscle, making it more complex than a subglandular procedure. This also increases pain and tightness during the first week. As the muscle adapts to the implant during the healing process, the tightness decreases. The full settling process usually takes several months.
Submuscular placement is a method that has been used in cosmetic surgery for many years. It provides more natural results, especially in people with thin breast tissue. Because the implant is covered by the muscle, the contours appear softer, and the risk of rippling is lower.
Which technique looks more natural?
Submuscular placement provides a more natural appearance. The implant is better covered by the muscle and breast tissue; therefore, the contours are softer. In patients with a slender build, it yields much more natural results compared to subglandular placement. However, it would be incorrect to consider this a rule. In other words, we cannot say that submuscular placement always provides a better and more natural appearance. A natural appearance can also be achieved by adding a small amount of fat tissue in addition to subglandular placement. In some patients, dual placement may yield more effective results. That is, submuscular and subglandular placement can be used together. For this reason, the surgeon makes the right decision by evaluating the patient.
Which placement is better for athletes?
The range of motion of the muscles is important for professional athletes. In patients who engage in intense chest muscle training (fitness, CrossFit, swimming, bodybuilding), the implant may move upward when the muscle contracts due to submuscular placement. This movement is both visually disturbing and may cause pressure in the implant area during training. For this reason, subglandular implant placement is a better option for professional athletes seeking breast enlargement in Antalya.
How implants move and settle over time?
After breast augmentation surgery, the implant does not settle immediately. It takes approximately one month for the body to adapt to it and for the final appearance to be achieved. This period is longer for submuscular implants and shorter for subglandular implants.
In addition, during the surgery, the surgeon prepares a space for the implant when placing it above the muscle. The breast implant remains in this area after the surgery. However, this is more difficult to achieve when placing the implant under the muscle. Therefore, the implant may sometimes move.
Which option is better: Over the muscle or under the muscle?
Breast implant placement is a surgical procedure, so no single method can be considered universally correct. Each approach may have its own specific complications. Breast enlargement surgeries generally do not pose significant risks.
Surgeons' approach to breast implant placement is as follows: The best method is the one that best suits the patient’s breast structure, expectations, skin thickness, and lifestyle. A surgeon’s goal is to evaluate these criteria in each patient and determine the best method that will function without problems for many years and remain compatible with the patient.