Breast implants – Under or Over the Muscle?

Breast Implant Surgery

There are a couple of different locations where implants can be placed during breast implant surgery at our Sydney-area plastic surgery practice. The breast implant can be placed either over the muscle (called “subglandular”, as it is sitting directly underneath the breast gland). Alternatively, the breast implant can be placed underneath the muscle (called “submuscular” as the implant is largely covered by the pectoralis major muscle). A/Prof Damian Marucci can discuss which placement option is best suited to your particular case during your initial breast augmentation consultation at his state-of-the-art clinic.

Submuscular or Subglandular, placement options during breast implant surgery
Breast implants can be placed “subglandular” (on top of the muscle) or “submuscular” (under the muscle)

Subglandular – Over the Muscle

Patients who have good soft tissue cover over the upper pole of theirs breast can have the breast implant safely placed directly underneath the gland, without the risk of the shape of the implant being visible underneath the skin. The key measurement to determine whether this is the case, is the soft tissue pinch test, which is performed during the tissue measurements used to determine breast implant size and optimal placement locations.

There are a few advantages to a subglandular placement:

  • The post-operative pain tends to be less than going under the muscle
  • The implants can be positioned closer together on the chest wall to give a more defined cleavage – although bear in mind that the centre of the implant must be under the nipple.
  • There is a slightly decreased risk of post operative bleeding when compared with going under the muscle

Submuscular – Under the Muscle

Many patients who request breast implant surgery have thin soft tissues over their upper chest wall and so require the implant to be placed underneath the muscle.

The advantages of submuscular placement are:

  • Better camouflage of the upper pole of the breast implant under the soft tissues of the upper chest
  • Decreased risk of capsular contracture
  • Good visibility of the breast tissue during mammograms

A/Prof Damian Marucci, like many specialist plastic surgeons, often combines the benefits of the submuscular with the benefits of subglandular by developing a “Dual Plane”. This is where the implant is placed under the muscle during breast augmentation, but then the gland on top of the muscle is partially released so the implant can slide under the lower gland.

Pect major elevation
The pectoralis major muscle is carefully identified and lifted
Submuscular pocket complete
The submuscular pocket has been created.
Breast implant placement
The implant is placed into the surgical pocket

Learn More about Implant Placement during Breast Implant Surgery

To learn more about the optimal placement of implants during breast implant surgery, please contact our Sydney-area plastic surgery practice, with locations in Kogarah and Miranda, today.