Is it better to place the implant under the muscle?
Is it better to place the implant under the muscle?

Since the invention breast implants, there is a discussion about the location of the breast implants. Implants over or under the muscle? Many clinics and surgeons swear by the location of the implants under the pectoral muscle and teach this type of placement to many more future cosmetic surgeons. This article explains the different kinds of placements and which method is suitable for whom.

What are the possibilities for the position of the implants in breast augmentation?

Basically, there is the possibility of placing the breast implants in front of the muscle (subglandular breast augmentation) and breast augmentation under or behind the muscle (submuscular breast augmentation).

Implants under the pectoralis muscle

In breast augmentation under the pectoral muscle, the muscle is partially separated from the breastbone and the implant is pushed underneath. The chest muscle covers a maximum of 40% of the implant. Why this method has some disadvantages and is therefore rarely used will be explained below.

Implants over the pectoralis muscle

Breast augmentation over the chest muscle places the implants over the pectoral muscle so that they integrate ideally into the body’s existing tissue. This type of breast augmentation is preferred for aesthetic as well as practical reasons and is recommended to most patients. What speaks for this method is on the one hand a natural look. Most surgeons work in harmony with nature and want to retain the aesthetics of it. All volumetric fatty tissue of the female breast is located in front of the breast muscle. So why should an implant that is supposed to enlarge the breast be forced behind the muscle? Furthermore, the M. pectoralis (chest muscle) is a flat and flat tissue. The muscle is severed during an operation and the implant is pushed underneath. This leads to a strong and unnatural stretching, which is associated with great pain and a functional impairment. It loses by cutting about 25% of its strength.

Admittedly, this does not occur too much in everyday life, but can lead to significant restrictions for women athletes. Furthermore, the muscle pushes on the implant with every movement. This can lead to unsightly deformation and material fatigue. Another not insignificant problem is that implants under the muscle often “stick” to the cutting line. This leads to the so-called “double bubble” phenomenon in which a kind of edge forms in the lower part of the breast and leads to an unsightly change in shape of the breast.

Which implants are better suited for the position under the pectoral muscle and which for the position above the pectoral muscle?

Both forms can be used for both methods, depending on the individual wishes and anatomical conditions of the patients. However, most surgeon recommend the location of the implant over the pectoral muscle.