Breast Implant Placement: Over or Under the Muscle?

Along with implant size and type, another decision Dr. Pancholi will help you make before moving forward with breast augmentation surgery is where your breast implants will be placed. While each implant placement option involves specific techniques, they can basically be described in terms of being above or below the pectoral muscles of the chest.

Subglandular implant placement: Over the Muscle

When implants are placed underneath your existing breast tissue, but above the chest muscles, (pectoralis major & minor), this is known as subglandular placement. While placing the implant under the muscle provides many benefits, subglandular placement (on top of the muscle) can be the right choice for many, especially those women with sagging breast tissue that may need a breast lift. Placing the implant on top of the muscle in this situation can often create the appearance of lifted breasts without the need, cost, recovery, and scars from an actual breast lift.

Advantages of over-the-muscle implant placement

  • You’ll have less post-op discomfort. Since the muscles are not affected in the procedure, swelling is less and patients experience less pain.
  • The recovery is quicker, and your final results can be in place within weeks after surgery.
  • Flexing your chest muscles will not affect the shape of the implant.


  • Increased risk of capsular contracture. In the past, textured implants were recommended for women who choose this placement option. However, with the current association of BIA-ALCL with certain textured implants, I now recommend utilizing smooth covered implants.
  • Mammography results may be more difficult to read resulting in the need for additional studies such as an ultrasound or CT scan.
  • If you have little natural breast tissue, you are more likely to be able to feel the implants in the breast.

Subpectoral implant placement: Under the Muscle

The other option is to have your breast implants placed beneath the larger chest muscle (pectoralis major).

Advantages of subpectoral implant placement

There are many benefits to having your implants placed beneath the chest muscle, including:

  • More cushion between the implant and your skin makes it harder to feel the edges or see rippling
  • Reduced risk of capsular contracture
  • Softer transition between the rib cage and breast
  • Better views in mammography


There are a few drawbacks to subpectoral placement you should be aware of before you make your decision:

  • Initial recovery is more uncomfortable. The chest muscle will have stretched and the initial discomfort from this can take 4 to 5 days to subside.
  • It takes a little longer to see your final results. Your breasts will typically need about 2 to 3 months to settle into their final position.
  • You may feel or notice the implant move with activity. Certain chest exercises can cause the breast to change shape while you are doing the exercise. This won’t permanently affect the look of your breasts; it just feels a bit strange until you get used to it.

What else do I need to consider?

Remember, every aspect of your breast augmentation will be guided by what’s best for you personally: your body, your desired look, and your health. Dr. Pancholi will help you choose the best implant placement option for you based on the amount of breast tissue you have, the type of implant you choose, your personal preferences, and whether or not you’re having a breast lift at the same time.


Regardless of which breast implant placement option you choose, Dr. Pancholi will center the implant behind the nipple to provide a symmetrical result.

Choose your breast implants at a consultation

If you’re ready to explore your options for breast augmentation, call our office for your consultation with Dr. Pancholi. Breast cosmetic surgery is his specialty, and he will help you choose the right implants as well as the best placement technique for your needs.