Above or Under the Muscle: Which Is Better Placement for Breast Implants?

There is much debate over the optimal location for breast implants in regard to the pectoralis muscle, when used to augment small breasts. Most plastic surgeons recommend placing the implants under the muscle for the following reasons:

1) Less incidence of capsular contracture

2) More natural look with a better transition from upper chest to breast. Less “fake” augmented look. Many people equate implants on top of the muscle has the Pam Anderson fake look.

3) Radiologists prefer visualizing the breast tissue with the implant behind the muscle.

However, there are some patients who are better suited for placement in FRONT of the muscle. These include but are not limited to very muscular and body builder type patients. For them the animation of their breasts with implants under the muscle would not be acceptable. The other category of patients are women who have constricted breasts or tuberous deformities. These patients need to have the breast tissue radially scored and recontoured to achieve a more aesthetic shape.

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