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Best Breast Implant Placement – Over The Muscle, Under The Muscle Or Dual Plane?

When it comes to breast implant placement, several techniques can be performed based on your specific needs. Depending on your goals and the preferences of your surgeon, the breast implants can be placed over the chest muscle, under the chest muscle, or partially behind the chest muscle and partially behind the breast tissue (dual plane). Multiple factors play a role in determining the placement of the implant. Some of the most common factors include the patient’s body type, overall health, and type and size of implants.

Before breast augmentation, your plastic surgeon will evaluate your body anatomy, general health, expectations, and goals to determine the best breast implant placement for you. However, as someone interested in getting implants, you must be aware of the pros and cons associated with each placement technique. Let’s look into each of the techniques.

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Over The Muscle Placement (Sub-Glandular Breast Implant Placement)

This technique involves the placement of an implant between the chest muscle and breast tissue.

Pros of the Sub-Glandular Placement

  • It gives a more prominent breast shape as implants are placed close together.
  • Patients can opt for a larger breast size.
  • Implants are not distorted with the flexing of chest muscles.

Cons of Sub-Glandular Placement

  • Such implants are supported by skin which can cause stretch marks in the future.
  • Your breasts are more susceptible to visible ripping of the implants.
  • It can interfere with mammograms.
  • It can affect your breastfeeding ability.
  • There is an increased risk of bottoming out as well as capsular contracture.
  • There is a higher chance of loss of sensation in nipples as this technique might restrict blood flow to the nipple.

Under The Muscle Placement (Submuscular Breast Implant Placement)

This technique involves placing the implant under your chest muscle.

Pros of Submuscular Placement

  • It has a lower risk of rippling of the implant.
  • It has a lower risk of animation deformities (visible distortion or displacement of the implants due to chest muscle movements).
  • It has a lower risk of capsular contracture.
  • Patients don’t experience stretch marks as the implants are not entirely supported by the skin.
  • It is a great option for those who might be interested in getting a breast lift after the procedure.

Cons of Submuscular Placement

  • It requires more invasive techniques.
  • The recovery period is longer and involves more discomfort.
  • Your breasts will appear a bit higher for the first few months after the surgery.
  • There is a higher chance of implant distortion.
  • Such implants might not be suitable for all body types.

Dual Plane Breast Implant Placement

A dual plane approach separates the breast tissue from the pectoral muscles while keeping the implant in a submuscular position.

Pros of Dual Plane

  • It has a lower risk of visible ripping of the implant.
  • It has a lower risk of capsular contracture.
  • It has a lower risk of animation deformities.
  • It results in an increase in projection and fullness in the upper portion of the breast.

Cons of Dual Plane

  • It requires complex surgical techniques resulting in more discomfort in the earlier stages of recovery.
  • It is associated with longer recovery time due to the complexity of the procedure.
  • It has a higher risk of implant malposition or displacement.
  • It can interfere with mammograms.

Who is the Right Candidate for the Over / Under / Dual Plane Breast Implant Placement?

During your consultation, one of our Melbourne plastic surgeons will conduct a detailed assessment of your general health and expectations. Based on these assessments, your surgeon will determine the most suitable breast implant placement technique. The technique usually depends on your aesthetic goals, existing breast tissue, and overall body physiology.

For instance, a dual plane technique is generally recommended for women who have mild to moderate breast sagging and thin breast tissue. On the other hand, submuscular breast implant placement is ideal for women who have thin or insufficient natural breast tissue and breast asymmetry. The sub-glandular breast implant placement technique is recommended for women who have adequate natural breast tissue.

The final implant placement decision will depend on several factors, such as your body’s anatomy and general health. During the consultation period, your surgeon will assess these factors to determine the most suitable breast implant placement specific to your needs.

Breast Implant Placement FAQs – Questions about Implant Location

Is it better to go under or over the muscle?

Both techniques work great, and choosing one over the other entirely depends on your aesthetic goals, body type, and general health. Your surgeon will assess these factors to determine the best breast implant placement based on your specific needs.

Do implants under the muscle look smaller?

Yes. They may appear slightly smaller due to the additional coverage provided by the muscle tissue. The muscle can compress the implant slightly, which gives it a smaller appearance.

How do you tell if implants are under the muscle?

Place your hands on your hips and press inwards. Now, look at your breasts. If the top of your breast has flattened, the implant is placed behind your muscle. If the top of your breast doesn’t go flat, implants are placed over the muscle.

Can over-the-muscle implants look subtle?

This depends on various factors such as your body anatomy, the size and shape of the implants chosen, and the surgeon’s skill and technique.

How many ccs do you lose under the muscle?

Patients can lose anywhere between 30 to 50 cc. Surgeons usually recommend going a size up to make up for this difference.

How long do breast implants under the muscle last?

The implants can last anywhere between 10 to 20 years regardless of where they are placed. The longevity of breast implants will depend on several factors, such as implant type and quality, surgical technique, and lifestyle.

Will under-the-muscle implants get bigger?

Initially, your breasts will be swollen. The swelling subsides after a few weeks. During this time, your implants settle into their final position and size. Over time, the surrounding muscle and tissue adjust to accommodate the implants. This change does not result in a significant increase in the size of the implants.

Will my implants look bigger if I lose weight?

Breast implants will not get any bigger or smaller if you lose weight. However, they might appear bigger in comparison to a smaller body.

Why do my implants look so small?

If you feel that your breast implants are looking small, it can be due to several factors. When the swelling goes down, you might feel that the implants are looking smaller. On the other hand, the cup size cannot be fully predicted. So, some patients might feel that their breasts look smaller than they expected.

Can you go bigger after breast augmentation?

Yes. You may undergo breast augmentation revision surgery to exchange your existing breast implants for larger ones. You can always discuss the possibility of going bigger with your surgeon so that he or she can guide you properly.

How soon can I get bigger implants?

It is advised to wait for a period of six to twelve months before you decide to go bigger with the implants. Your breast implant surgeon will advise you regarding the right time to undergo breast augmentation revision surgery to exchange your existing breast implants for larger ones.

How can I make my implants look natural?

Tell your surgeon about your preference, and he/she will guide you through the process of selecting the right type of breast implants and their placement. Your surgeon will help you choose an implant that looks proportionate to the rest of your body.

Considerations Before Choosing a Breast Implant Technique

Here are the four things that you and your surgeon should consider when choosing your breast implant placement technique.

1. Aesthetic Considerations

Each technique produces a different aesthetic result. For instance, an over-the-muscle breast implant placement will give you a more prominent breast shape. On the other hand, a dual plane and under-the-muscle breast implant placement can increase the projection and fullness of the upper portion of the breast.

2. Breastfeeding Concerns

Some women plan to have babies after they have gotten the implants. For some people, breastfeeding their children is important. If that’s the case, discuss it with your surgeon in advance so he/she can choose a suitable technique for you. Some techniques can affect your breastfeeding ability, so discuss this matter during consultation.

3. Your Physiology, Skin Quality and Genetics

Your general body composition will play an important role in determining which technique will suit your body best. At times, surgeons can go ahead with only one technique. The general physiology of the body is the most important deciding factor.

4. Your Surgeon’s Skills and Preferences

When considering breast implant placement, you should consider your surgeon’s expertise. Some surgeons prefer one technique over the other. Look for a surgeon with the right skill set.

Breast Implant Placement Summary

Breast implant placement plays a crucial role in achieving optimal results. Subglandular breast implant placement, positioned above the chest muscle, gives a more prominent breast shape as implants are placed close together.

Submuscular breast implant placement, which is under the muscle, has a lower risk of capsular contracture, animation deformities, and rippling. A dual plane and under-the-muscle breast implant placement can increase the projection and fullness of the upper portion of the breast.

Most importantly, the choice of breast implant placement should be based on your specific needs. Several factors, such as your body anatomy, aesthetic goals, lifestyle, age, and overall health, will determine the placement of the breast implant.

Furthermore, your surgeon will thoroughly assess these factors to determine the most suitable breast implant placement.

Specialist Plastic Surgeons and ENT (Ear, Nose and Throat) Surgeon

With a wealth of experience and training, our Specialist Plastic and ENT (Ear, Nose and Throat) Surgeons are dedicated to best-practice patient care and education, customising Surgery for each and every patient to best meet their needs and desired surgical outcomes.

Dr Craig Rubinstein
Dr Broughton Snell
Dr Stephen Kleid
Dr Gary Kode

Specialist Plastic Surgeon MED0001124843

Dr Craig Rubinstein

Dr Craig Rubinstein is a Specialist Plastic Surgeon based in Hawthorn East, Melbourne. With over 20 years of surgical experience especially in all areas of Cosmetic and Plastic Surgery, but particularly in breast surgery. These include Breast Augmentation and Breast Reduction as well as Breast Surgery Revision.

Furthermore, he believes that surgical customisation, precision planning and technical expertise help him to provide optimal surgical outcomes for his patients.

Specialist Plastic Surgeon MED0001190266

Dr Broughton Snell

Dr Broughton Snell is a Specialist Plastic and Reconstructive Surgeon based in Melbourne, Victoria, Australia. His training in Plastic Surgery took place in Australia and the United States of America (USA).

Dr Snell is a fully qualified specialist plastic surgeon having completed his Fellowship with the Royal Australasian College of Surgeons in plastic and reconstructive surgery. He has also spent time following the completion of this qualification gaining further experience and training in the area of craniomaxillofacial surgery, training which he completed in world-renowned centres here and in the United States.

ENT (Ear, Nose and Throat) Surgeon MED0001052799

Dr Stephen Kleid

Dr Stephen Kleid is an experienced Ear, Nose and Throat (ENT) Surgeon (Otolaryngologist) based in Melbourne with a passion for Septo-rhinoplasty, Septoplasty, as well as, a strong interest in Rhinoplasty Revision.

Dr Kleid trained at Melbourne University, then completed surgical training at various hospitals including Royal Melbourne, Royal Children’s, The Eye and Ear and St Vincents. He worked as a surgeon at the University of Florida Medical school for further experience.

Specialist Plastic Surgeon MED0001405964

Dr Gary Kode

Dr Gary Kode is a Specialist Plastic Surgeon, with experience in Aesthetic and Reconstructive Surgery, as well as non-surgical treatments.

Dr Kode is a member of several organisations, including the Australian Society of Aesthetic Plastic Surgeons (ASAPS), The International Confederation for Plastic and Reconstructive and Aesthetic Surgery, and he holds a Fellowship with the Royal Australasian College of Surgeons.

What to do next?

Our Patient Liaison Team can assist with any questions you may have when considering a procedure. You can send in an enquiry form below or call our Melbourne Clinic between 9 am – 5 pm Monday - Friday.

Disclaimer: Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon.

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