• 30 October 2023
  • Mr A. Siddiqui

Last updated on October 30, 2023

A big decision with breast augmentation comes down to a debate of under the muscle vs over the muscle implant.  There is no one-size-fits-all and both options have merits and disadvantages, which we will explore in this article.

Why is breast implant placement important?

You want natural-looking breast enhancements that suit your body shape and size and that sit properly on your chest. This comes down to proper breast implant placement.

Everyone has different body shapes and sizes with differing amounts of breast tissue. When it comes to muscle vs over muscle breast implants, these differences determine the best procedure for you. An experienced surgeon will provide the best advice to help guide your decisions. In the meantime, keep reading to discover more information about muscle vs under muscle implant options.

What is the difference between over-muscle and under-muscle breast implants?

Your breast is made up of fatty (adipose) tissue, mammary ducts, and a layer of muscle known as the pectoralis major muscle. Over-muscle breast implants are placed underneath your natural breast tissue but over the top of the pectoralis major muscle. Implants under the muscle sit underneath both the natural tissue of your breast and the pectoralis major chest muscle.

Over the muscle breast implant placement - Breast & Body Clinic

A diagram showing the different placement options for under or over the chest muscle.

Over-the-muscle breast implant placement

Over-the-muscle placement is also known as subglandular placement and is recommended for women with larger amounts of natural breast tissue. This provides ample coverage and support for your new implants and creates a natural-looking cleavage enhancement.

Pros of over-the-muscle placement for breast implants:

  • Shorter surgical and recovery time.
  • Less pain post this procedure as opposed to under the muscle implant placement.
  • No diminished strength as the chest muscle remains intact.
  • Can insert larger implants.
  • Better cleavage as the implants can be placed closer together.

Cons of over-the-muscle breast implants:

  • As the upper edges of the implant are closer to the skin, they can be more visible creating a rippled or wrinkled appearance.
  • They can interfere with mammograms.

Under the muscle breast implant placement

Submuscular or under-the-muscle implant placement is reserved for those women who have smaller amounts of breast tissue, meaning smaller breasts. In this case, the chest muscle provides coverage and support for the implants.

Pros of under-muscle breast implant placement:

  • Achieves a smoother transition between your implant and chest wall.
  • Generally has the most natural-looking results.
  • Interferes less with mammograms.
  • The upper slope of your implant will have more tissue coverage.
  • Archives a natural breast contour.

Cons of under-the-muscle implants:

  • Your pectoralis major chest muscle will need to be cut to insert the implant.
  • The surgery is longer and the recovery can be more uncomfortable.
  • This can result in decreased chest muscle strength.
  • Implants can distort with the contraction of your chest muscle.
  • There is a higher chance that your implant will migrate upwards, or have deformities.
How to decide the best breast implant placement for you - Breast & Body Clinic

There are pros and cons to both placement options, so it will come down to your surgeon’s recommendations, your body type, and your expectations.

How to decide the best breast implant placement for you

Now you know all about the pros and cons of each placement, how do you decide which is best for you? There are several important factors that will help guide this decision, which we touch on below.

How much natural breast tissue and chest muscle do you have?

Women with very little breast tissue are advised to have implants under their chest muscles. This provides the most natural-looking enhancements for smaller cleavage sizes. The pectoralis muscle will provide adequate soft tissue coverage that disguises the edges of the implant, which thin breast tissue doesn’t.

Women with larger amounts of tissue and chest muscles are better suited for over-muscle placement. The larger amounts of natural tissue over the breast cover the outlines of the implants, creating a natural-looking enhancement.

What type of breast implants do you want?

There is a decreased risk of rippling and visibility with silicone implants, so they are a good option for an over-the-muscle procedure. Silicone breast implants also have more options for sizes and shapes, in comparison to saline implants. However, many people report that saline implants feel more natural. It will come down to personal choice, your goals for the end results, and the recommendation of your surgeon.

right implant placement for you - Breast & Body Clinic

Your surgeon will discuss in great detail the best option for you based on your body type and the amount of tissue in your chest and breasts.

The right implant placement for you

It’s important to make sure that you get the right breast implant and placement for you. With an under-the-muscle breast augmentation, your new breast implants are placed underneath your breast tissue and pectoral muscle. This is different from over-the-muscle enhancements, which are placed over your chest muscle but under your natural breast tissue.

The type of implants you choose and placement will depend on your body type, goals, and expectations. A qualified and experienced plastic surgeon can provide the best advice based on your unique physical appearance as to whether over or under-muscle implants are best for you. In addition to implant type and placement, there are also a variety of breast procedures available, such as breast lift or breast reduction, that can help address concerns such as sagging or asymmetry. It’s important to have a thorough consultation with your surgeon to discuss all available options and determine the best breast procedure or combination of procedures to help you achieve your desired outcome.


Check out some of our frequently asked questions about implant placement options.

Do implants under the muscle look smaller?

No, implants under the muscle do not look smaller. The final shape and size of an enhancement are determined by your body type and the size of the implants being inserted, not the placement.

Can over the muscle implants look natural?

Over the muscle enhancements look natural if you already have a larger cleavage with more breast and chest tissue. If you have very little natural breast tissue then plastic surgeons recommend under the muscle procedures for a more natural-looking breast enhancement.

Do over the muscle implants sag more?

No, over the muscle breast augmentation does not sag more than under the muscle. Over time the tissues and skin of your breast and chest will naturally lose elasticity due to age or weight changes and can result in sagging.

What is the most popular implant placement option?

It is not a popularity contest between implant placement options. Rather it comes down to what is best for you, your unique body type and what your expectations for a breast enlargement are.

Mr A. Siddiqui
About The Author

Mr A. Siddiqui

Mr Siddiqui is a Consultant Plastic and Cosmetic Surgeon, based at The Countess of Chester Hospital in the Department of Plastic and Reconstructive Surgery. He trained extensively in plastic surgery before becoming a Consultant in the NHS and developing a private practice in Manchester and other areas of the Northwest. He is considered to be one of the top 10 cosmetic surgeons in Manchester.

Are You a Candidate for Tummy Tuck Surgery?

If you’re considering getting a tummy tuck, knowing when to get the procedure is very important.
Take our quiz to find out if you should start thinking about scheduling your tummy tuck surgery today.


©2023 Breast and Body Clinic | All Rights Reserved
Powered by powered by online marketing for doctors Online Marketing For Doctors