Deciding to undergo breast augmentation surgery is a significant decision, and one of the most essential choices you’ll make is implant placement. As a board-certified plastic surgeon, I know that achieving beautiful results goes beyond just selecting the right implant size or shape; it’s about determining a placement that complements your aesthetic goals, body frame, and lifestyle.
In this post, I’ll explore how factors like physical activity, fitness goals, and personal preferences are critical in determining the ideal implant placement for a breast augmentation. I’ll also discuss how adding a breast lift to your procedure influences the decision between submuscular and subglandular placement.
Understanding Implant Placement: Over vs. Under the Muscle
There are two primary options for breast implant placement, each with its unique advantages and considerations:
- Subglandular (over the muscle breast implants): The implant is positioned above the pectoralis major muscle, directly beneath the breast tissue. This placement often provides a rounder, fuller appearance, particularly for women with sufficient existing breast tissue. If you enjoy an active lifestyle, it also typically allows for more freedom of movement, especially for upper body-intensive activities.
- Submuscular (under the muscle breast implants): The implant is placed partially or fully beneath the pectoralis major muscle. This method offers a more natural look, especially for women with less natural breast tissue, as the muscle provides additional coverage and support. However, this placement comes with the risk of animation deformity—the distortion or movement of implants during muscle contraction.
The choice between these options depends on various factors, with lifestyle being a key consideration. During your personalized consultation, we’ll discuss the pros and cons of your implant placement and incision options.
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How Does Adding a Breast Lift to Your Augmentation Affect Implant Placement?
For women combining a breast implant with a lift, the decision of where to place the implants is influenced by
- The amount of native breast tissue
- Degree of ptosis (sagging)
- Skin quality and laxity
- Aesthetic goals
- Risk tolerance and surgical complexity
Breast lift patients often have stretched or weakened breast tissue, which may not provide adequate support for an implant in a subglandular position. Submuscular placement is often favored in these cases because the muscle offers extra support, helping reduce the risk of long-term sagging (aka “bottoming out” or “double bubble” deformity).
A breast lift often requires skin tightening and repositioning of the nipple-areolar complex, which adds complexity to the procedure. Surgeons may lean toward submuscular placement in combination procedures to better preserve vascular supply to the nipple, especially in more extensive lifts (e.g., anchor or vertical techniques).
How Your Lifestyle Habits & Goals Dictate Implant Placement
Let’s take a closer look at how your daily habits and long-term lifestyle goals guide the choice for your breast implant placement by exploring these key questions:
Are You a Fitness Enthusiast?
Placing the implants over the muscle might be a better option if you’re passionate about lifting weights or intense upper-body activities like climbing or rowing. This prevents potential distortion from pectoral muscle movement, which can happen with implants placed underneath it. That said, under-the-muscle placement can still work beautifully if you’re active, depending on your goals—we’ll talk through this together during your consultation.
Are You Planning To Have Children in the Future?
While breast implants and lifts don’t interfere with pregnancy or breastfeeding in most cases, your long-term goals are essential. If you’re planning to become pregnant or breastfeed, we’ll factor in the possibility of additional breast changes over time. You may benefit from under-the-muscle placement to help maintain long-term upper pole fullness, especially if you have minimal natural tissue.
What’s Your Tolerance for Downtime?
Healing time varies slightly depending on implant placement. Generally, over-the-muscle placement comes with less initial discomfort and a quicker recovery since the muscles aren’t disrupted. This may appeal to women who want to resume regular routines quickly. Submuscular placement may require a little more time before returning to strenuous activity, but this is a temporary tradeoff for many long-term benefits.
Take the Next Step! Your Lifestyle, Your Ideal Look
You deserve results that look beautiful, feel natural, and align with your lifestyle. During your personalized consultation, we’ll have an open, thoughtful conversation about your goals. I’ll take the time to understand your unique needs and design a surgical plan that’s tailored to help you achieve a look you love—one that’s both timeless and true to you.
Get started by reaching out for your personalized breast augmentation consultation. I encourage you to request a consultation using the online form or by calling our practice at (208) 881-5351.
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