The Pros and Cons of Over the Muscle Breast Implants

Updated on: April 1, 2019

You've heard that breast implants can be placed in front of the muscle and behind the breast tissue, but what are the advantages and disadvantages of going this route?

Over-the-muscle breast implant placement

Over the Muscle - In front of the muscle, and behind the breast tissue.

Pros of over-the-muscle breast implant placement

  • Implants are very easy to place. Virtually all surgeons can perform this procedure with ease.
  • A breast lift, or mastopexy, due to mild sag (ptosis), may be needed in the future, especially when larger implants are placed. Keep in mind that the only thing supporting the implant is the skin and breast tissue.
  • Less recovery time, with less post-op discomfort/pain, since the muscles are left in tact, and only skin and fat are cut.
  • Larger implants may be placed, versus attempting to use a very large implant with partial or complete sub-muscular placement (during the first augment).
  • Cleavage is more easily created with overs, particularly if the breasts are naturally spaced wide apart.
  • Many women who lift weights opt for over the muscle placement. This is mostly due to the fact that when the pectoral muscles are flexed, the implant does not become distorted in shape.

Cons of over-the-muscle breast implant placement

  • Ripples are more easily seen and felt, especially in women starting with little or no breast tissue. In these cases, there is very little tissue to help camouflage the implant. This is especially true for textured breast implants placed over the muscle. See photos of rippling here.
  • More pictures/views will need to be taken when doing mammograms, and sometimes, insurance companies will not pay for these extra images, which means you will have to pay for those out-of-pocket. However, his can be true no matter where the implants are placed.
  • Capsule contracture rates are highest in women with implants placed over the muscle.
  • Bottoming out is a larger risk with overs and partial-unders than with implants placed in the complete submuscular position.
  • Overs can give a more "fake", augmented look. There tends to be more of a pronounced "roundness" to the breasts, versus the look that unders give, which is a more natural slope. Again, this is not the case for ALL sub-glandular implants, but does seem to be truer for those who have little to no breast tissue to start with. There is nothing at all wrong with this look. It's simply a matter of personal preference.
Updated October 2016

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