Breast Enlargement with Breast Implants

Treatment information


Above or below the muscle

There is the choice between having a breast implant put on top of the muscle (also called the sub glandular placement), or underneath the muscle (the sub muscular placement). The muscle in question is the chest muscle.

If the implant is placed on top of the muscle, it will lie between the chest muscle and the actual breast tissue. If the implant is placed underneath the muscle, it will sit in the pocket between the large chest muscle and the ribs. You Figure 1 shows the different placement options

Placement of the implants - above or under the muscle
Fig. 1. Placement of the breast implant above or underneath the chest muscle

Whether the implant should be placed over or under the muscle depends on the patient's build, and particularly on the shape of her breasts.

If the breasts are already sagging, the implant will usually be placed on top of the muscle, in order to make sure that the implant will not end up sitting too high, in comparison with the natural breast tissue. Especially with very slender patients, you will often be able to see the line where the implant starts, if the implant is placed above the muscle. If the patient is very slender and already has perky breasts, the best solution would be to place the implant underneath the muscle.

General benefits with an implant underneath the muscle are that it will be more difficult to feel, and it will also make it easier to have a mammogram (screening for breast cancer).

If a placement underneath the chest muscle is chosen, it will be necessary to loosen the bottom part of the muscle, in order to avoid flattening the implants when the patient tightens the muscle. Due to this, the patient will experience more pain during the days after the surgery, than if the implant had been placed over the muscle. The procedure also takes longer, and a potential follow-up procedure will be more difficult.

The benefits of having the implant placed on top of the muscle are that the time of healing is shortened, and a potential follow-up procedure would be less difficult.

During the preliminary consultation, the surgeon will be able to counsel the patient regarding the best placement for her implants.

Source and illustrations: Sundhedsstyrelsen.