Breast lift with implants: under or over the muscle?

Breast lift with implants: under or over the muscle?

15th Jul 2014

Choosing between saline and silicone implants is just the tip of the iceberg when you’re planning for your breast augmentation here at our Houston breast enhancement surgery practice. In addition, there are other aspects of the procedure that you also need to consider, one of which is deciding about implant placement.

By and large, implant placement can either be submuscular (under the muscle) or subglandular (over the muscle and beneath the breast tissue). The muscle in question is the pectoralis major muscle and either placement have their own set of pros and cons. Let’s take a closer look between the two below! 

Submuscular Placement (Under the Muscle)

Placing the implant underneath the pectoralis major muscle has the advantage of making the implant look more natural because there is more breast tissue covering the implants. Thus, saline implants are often placed in this manner as they are often stiffer and firmer than silicone. The added weight of the breast will give way to a better shape of the upper part of the breast.


  • Rippling is less likely to happen if you choose to have saline implants
  • Better imaging results such as in mammography
  • Less chances of capsular contracture


  • Animation distortion may occur when the chest muscles are flexed particularly during exercise
  • Recovery tends to be more uncomfortable and longer with this placement as it can take a long time for the swelling to subside. Thus, it may take longer to see desired results.
  • Increased risk of the implant “bottoming out” 

Subglandular Placement (Over the Muscle)

Dr. Cortes recommends the subglandular placement if you choose to have silicone implants or want silicone implants but have a large amount of existing breast tissue. This type of placement is ideal for silicone implants because they are softer in texture and does not require large amounts of existing breast tissue. 


  • No animation distortion when the muscles are flexed
  • Shorter and less painful recovery times 


  • Increased chances of rippling when using saline implants
  • Saline implants may be more palpable and visible
  • Capsular contracture may be more apparent when using smooth implants

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