Breast Implant Placement

Breast Implant Placement

Breast implants can be placed either over the chest muscle but under the breast tissue (subglandular) or over the chest muscle (submuscular). There are also partial unders where the implant is located under the upper part of the pectoral (chest) muscle. In this guide, we look at the advantages and disadvantages of each of these three different implant placements and explain under what circumstances each of the options may apply to you.

Since you have a choice here, we recommend that you gain an understanding of the options and then discuss them with the surgeon at your breast enlargement surgery consultation. If you want the best results for your personal circumstances, then take advice from the surgeon at the consultation as to what is the best option for you. Note that some clinics only perform overs but please don't make the decision that overs are not for you without taking professional advice.

Subglandular breast implant placement: Over the muscle or overs

subglandular (overs) breast implant placement

With overs, the breast implant is positioned over the pectoralis (chest) muscle. The skin, fatty breast tissue, milk producing lobules and ducts to the nipple are all positioned over the implant.

Subglandular breast implant placement is the most common type in the UK. It is commonly used when there is sufficient natural breast tissue to cover and support the implants. However, this is not the only reason.

Advantages Disadvantages
Provides a more distinct cleavage More likely to sag over time because only skin an breast tissue support the implant
Allows for a larger implant placement Ripples may appear in women who have little natural breast tissue
Shortest recovery time and less discomfort and pain Higher risk of breast implant extrusion, particularly in those with little natural breast tissue.
Surgery is straightforward and implants are easy to place Can sometimes give a more rounded look rather than a natural shape. A matter of preference.
A slightly higher risk of capsular contracture

Submuscular breast implant placement: Under the muscle or full unders

submuscular (full unders) breast implant placement

With full unders, the top part of the breast implant is placed under the pectoralis (chest) muscle and the lower part is placed under the serratus muscles and rectus abdominus fascia. See glossary. The implant is covered and supported by muscle.

Unders are often performed where there is little natural breast tissue but this is not the only reason.

With unders, when the chest muscle contracts some twinging feelings may be experienced as the implant moves under the muscle e.g. during a workout. However, this is to be expected and normality is restored as the muscle relaxes. If you train regularly e.g. body builders, weightlifters and athletes, then you may want to consider overs for this reason and also because you may have little natural breast tissue due to a relatively low body fat percentage. Of course, this depends mainly on the genetics, diet and exercise of the individual. You should discuss this with the surgeon at your consultation.

With unders it can take from between a few weeks to a few months after surgery for the implants to drop into a more natural position. There are a number of factors determining this including muscle tone and implant size and texture. The implants will drop into their natural resting position when the muscle relaxes. If there has been no change after six months, you may need a massage. However, this will be covered in your aftercare and post-op, follow up consultations.

Advantages Disadvantages
Lowest risk of rippling Longer recovery times and most pain or discomfort
Lowest risk of capsular contracture More difficult to create cleavage, particularly if your breasts are naturally widely spaced
Lowest risk of breast implant extrusion Implants sit high on the chest at first and take time to settle
Gives a natural (non-rounded) look Surgical procedure is more difficult and invasive
The effects of fluffing can be more pronounced. Uniboob (symmastia) may occur. See symmastia, uniboob and fluffing.

Partial submuscular breast implant placement: Partial unders

With partial unders, the top two thirds of the breast implant is placed under the pectoralis (chest) muscle. The lower third is covered by fatty breast tissue.

The advantages and disadvantages are, as expected, a blend of overs and full unders.