When a breast augmentation is performed, the actual breast implant can be placed in one of two positions: under the muscle, or over the muscle. The muscle that this refers to is the pectoralis muscle, the strong chest muscle that can be seen when you flex your chest.

Over the muscle

Also called subglandular (under the breast gland), this approach positions the implant between the breast tissue and the pectoralis muscle.

A subglandular placement is often chosen for women with a larger volume of natural breast tissue or for those with a moderate amount of sagging of the breasts (as is often seen after breastfeeding).
Implants placed in this location usually produce breasts with a very full, round appearance.    

The advantages of placing the implants over the muscle include relative ease of the procedure and less early postoperative discomfort.

Under the muscle

Also called subpectoral (under the pectoralis muscle),

this approach positions the implant between the muscle and the rib cage.

Typically, the muscle will cover the upper 2/3 of the implant similar to a vest. The lower 1/3 of the implant is covered by the natural breast tissue.

This positioning helps to provide a natural, tear-drop shape to the breast. A subpectoral placement is often chosen for women with smaller natural breast volume and those with a minimum amount of sagging of the breasts.    

Advantages of placing the implants below the muscle include a more natural overall breast shape, decreased likelihood of interfering with breastfeeding and a decreased incidence of contracture (hardening).

There is no single approach that is ideal for every patient. At the time of your consultation, Dr. Brown will discuss with you in detail the options for implant placement so as to best meet your personal goals and expectations.