Under or Over (the muscle)? It's one of your key breast augmentation choices. And it can be a difficult choice to make!
'Under the muscle' is actually a bit misleading. Some plastic surgeons do place breast implants totally under the chest (pectoral) muscle. (See the middle boob in the picture below.)
However, in most cases 'unders' are only partially under the muscle. In a 'dual plane' position it's just the top half of the breast implant covered by the muscle and the bottom part (your lower pole) is under any existing breast tissue.
I've previously discussed the reasons why you might choose to go over the muscle during your breast augmentation so here are my top 5 reasons why you might choose to have your breast implants under the muscle.
Place your breast implants under If...
You're slim and you have very little breast tissue. A breast implant placed under the muscle will help 'hide' the implant better.
If you don't have much breast tissue to cover the breast implant, the muscle over the implant provides an additional layer of tissue to conceal the implant, meaning less chance of implant edges or ripples in the outer shell being visible.
You want to lower your risk of capsular contracture. Capsular contracture is excessive scar tissue building up around the breast implant squeezing the implant out of shape.
Medical studies have shown breast implants under the muscle reduce the risk of capsular contracture.
You want a more natural breast augmentation look. Implants placed under the muscle help to shape the upper pole slightly (the bit where the muscle is over the implant), which creates a more natural, gradual slope of the breast towards the nipple.
You're worried about breast implants affecting mammograms. Implants under the muscle tend to interfere with mammography less.
You haven't had children yet (or are planning more) and plan to breastfeed. The area where your breast implants are placed may affect your ability to breastfeed.
Breast implants placed directly under the breast tissue (overs) can interfere with milk production.
Still Not Sure Where to Place Your Breast Implants...
Under the muscle breast implant placement could mean a longer recovery, so it may take you slightly longer to get back to your usual activities. This shouldn't sway your decision though.
There are advantages and disadvantages to both placement options but most breast implants actually get placed under the muscle.
The key to your boobie journey is to find an experienced, certified plastic surgeon, to discuss your individual needs and preferences, to be fully informed about your choices and to make the best choices for you in collaboration with your surgeon.
Thoughts from Dr. Jeremy PyleSome of this is controversial (like capsular contracture rates) however, in my experience, implants above the muscle don't interfere with milk production (implants are behind the breast tissue, not in the breast tissue) but there are reasons that implants are placed behind the muscle in the vast majority of people.
This also gives me an opportunity to shoot down a myth on the internet: Implants behind the muscle don't lose cc's. I promise.