Under the Muscle — Submuscular Placement

What Is Submuscular Placement?

Submuscular (under the muscle) placement positions the implant behind the pectoral major muscle rather than in front of it. More specifically, most "under the muscle" procedures use a "dual plane" approach — the implant is partially behind the muscle at the top (where the pectoral provides additional tissue coverage) and in front of the muscle at the bottom (where the breast tissue provides coverage). True full submuscular placement, where the entire implant is behind the pectoral, is less common in modern augmentation practice.

Advantages of Submuscular Placement

Additional tissue coverage above the implant — the layer of muscle overlying the upper implant provides additional coverage that reduces implant edge visibility and rippling, particularly beneficial for women with less natural breast tissue. Lower capsular contracture rates in most studies. Better mammography images (the muscle layer separates implant from breast tissue, improving imaging). More natural-appearing upper pole — under-muscle placement avoids the "too round" look that can occur with subglandular placement of round implants in women with less natural tissue.

Disadvantages

More uncomfortable recovery — the pectoral muscle must accommodate the implant and initially spasms and tightens around it, causing more significant discomfort in the first week than subglandular placement. Animation deformity — in some women with submuscular implants, pectoral muscle contraction (during exercise or pressing movements) causes the implant to move or distort temporarily. This is more cosmetically relevant in very active patients. May not be suitable for all body types and aesthetic goals.