Breast Implant Placement: Should You Go Over or Under the Muscle? Here’s What You Need to Know
RJ Samantha 
Deciding to get breast implants is a big step, and if you’re doing your research – good on you! One of the most important decisions you’ll make during the breast augmentation process is where the implant will be placed.
That’s right – it’s not just about size or shape. Whether your implants go above or below the chest muscle can affect how your breasts look, feel, and even how they age over time.
Not sure which option is best? Don’t worry – we’re breaking down everything you need to know about implant placement so you can make an informed decision with your plastic surgeon.
What Is Breast Implant Placement?
Breast implant placement refers to the area in your chest where the implants are surgically positioned. There are two main options:
- Subglandular placement – Over the chest (pectoralis) muscle and beneath the breast tissue
- Submuscular (or subpectoral) placement – Underneath the chest muscle
Each has its own advantages, risks, and aesthetic outcomes, and the choice depends on factors like your body type, lifestyle, and cosmetic goals.
Why Placement Matters
Implant placement affects:
- The appearance of your breasts (especially the upper portion)
- How natural they look and feel
- Your recovery time
- Long-term risks like rippling or capsular contracture
- How well your breasts respond to mammograms
- How your implants behave during exercise or muscle contraction
So, yeah – it’s kind of a big deal.
Subglandular Placement (Above the Muscle)
In a subglandular placement, the implant is positioned above the pectoral muscle, but below the natural breast tissue. This is also called retroglandular or submammary placement.
Benefits:
- Shorter surgery and faster recovery time
- Less post-op discomfort since muscle isn’t involved
- More pronounced cleavage with smaller implants
- No distortion when chest muscles are flexed (ideal for bodybuilders)
- Often provides enough lift without a breast lift in some cases
Potential Drawbacks:
- Higher risk of rippling, especially in thinner women
- Implants may appear more artificial or “stuck on”
- Greater chance of capsular contracture (scar tissue hardening)
- Can interfere with mammogram readings
- Less support from underlying muscle
Best for:
Women with ample natural breast tissue, who desire a more dramatic look and have strong pectoral muscles, or want minimal downtime post-surgery.
Submuscular Placement (Under the Muscle)
In a submuscular placement, the implant is placed partially or fully beneath the pectoral muscle.
This method is sometimes called dual-plane placement, where the top portion is under the muscle and the bottom part sits under the breast tissue.
Benefits:
- Results in a more natural look and feel, especially in leaner women
- Lower risk of rippling
- Reduced likelihood of capsular contracture
- Better mammogram imaging due to deeper implant position
- More natural movement of the breast over time
Potential Drawbacks:
- Slightly longer surgery and recovery period
- More post-op soreness due to muscle involvement
- Temporary implant distortion during muscle flexing
- May take a few weeks to settle into natural position (“drop and fluff” phase)
Best for:
Women with less natural breast tissue, those seeking a subtle, natural contour, and anyone prioritizing long-term durability and lower risk of complications.
Subglandular vs Submuscular: At-a-Glance Comparison
| Feature | Subglandular (Over Muscle) | Submuscular (Under Muscle) |
|---|---|---|
| Recovery Time | Shorter | Longer |
| Pain Level | Lower | Moderate to High (initially) |
| Look | Rounder, more upper pole fullness | More natural slope |
| Feel | Less natural in thin patients | Softer and more natural |
| Capsular Contracture Risk | Higher | Lower |
| Rippling | More likely | Less likely |
| Mammogram Accuracy | May obscure results | Better clarity |
| Chest Muscle Interference | No | Yes (temporary distortion when flexing) |
How to Choose the Right Placement for You
Ultimately, the right placement depends on your anatomy, lifestyle, and personal goals. Ask yourself:
- Do I want a more natural look or a dramatic enhancement?
- Am I okay with a slightly longer recovery if the results are worth it?
- Do I have enough natural breast tissue to cover the implant above the muscle?
- Will I be engaging in activities that flex my chest muscles, like weightlifting or CrossFit?
- Am I concerned about future mammograms or scarring complications?
A board-certified plastic surgeon will help guide you based on your answers – but it’s smart to come prepared with clear priorities.
What Happens During Your Consultation
During your consultation, your surgeon will:
- Examine your breast anatomy and tissue thickness
- Review your medical history and lifestyle
- Use imaging or 3D models to simulate potential results
- Discuss incision types, implant sizes, and shapes
- Explain all risks, benefits, and recovery expectations
Don’t be afraid to ask lots of questions – the more informed you are, the better your results will be.
There’s no one-size-fits-all when it comes to breast augmentation. Whether you choose to place your implants over or under the muscle, what matters most is that your decision is informed, intentional, and aligned with your vision.
With the right surgeon and a clear understanding of your goals, you’ll be well on your way to results that make you feel confident, feminine, and happy in your skin.
