Breast Implant Location: Overs vs Unders?

During your breast augmentation consultation you may have a decision to make with your plastic surgeon: do you want your breast implants inserted under or over the muscle?

The difference between over and Under Breast Implants

And which one is right for your particular body?

Breast implants that are inserted over the muscle are placed between your natural breast tissue and your chest muscle.

Breast implants that are placed under the muscle are inserted beneath the muscle and also your natural breast tissue.

Which breast implant placement is best?

If you have very little breast tissue of your own, over the muscle breast implants might look unnaturally round and firm. This is especially true with saline breast implants, which are not as soft and squishy as silicone implants.

By placing saline breast implants under the muscle, the added pressure softens up and more naturally shapes the otherwise round and firm implant. Plus, under the muscle implants do provide an extra layer of protection.

Over the muscle breast implants have their own sets of benefits. If you have at least a B cup pre-surgery, over the muscle implants can appear very natural. If you have little to no breast tissue, over the muscle breast implants put you at risk for rippling or folding, especially with saline implants.

Silicone breast implants are often recommended for over the muscle because silicone is softer and more pliable in consistency than saline; this keeps implants soft and well shaped without the added weight of your chest muscle on top. Plus, if you lift weights or do push-ups, your implants won’t move as your chest muscles flex.

No two people are exactly the same and so the choice between over or under the muscle breast implants should be completely dependent on your body type and personal preference!

Thoughts from Dr. Jeremy Pyle

The over/under question is an important part of the consult as it is a very personal consideration and no article will solve it altogether. Here's my take on it though. There are at least six factors to consider:

1. How much breast tissue a person has (more tissue means less wrinkling).

2. How dense the breast tissue is (more dense means less wrinkling and more longevity to the shape).

3. How willing the person is to avoid Pec specific exercise for 6 weeks (if the answer is no, the implants should be above the muscle or we shouldn't do an augmentation).

4. What kind of an implant is being used. I won't put a saline implant above the muscle and would advise a denser gummy bear implant for most.

5. How comfortable the patient is with textured implants (textured implants above the muscle seem to decrease capsular contracture).

6. What type of result the person wants or needs (above the muscle implants sit lower on the chest)."