Newsletter: Breast augmentation below or above the muscle?

In breast augmentation, one of the most important questions is: will the implant be placed above or below the chest muscle?

Both techniques have their own advantages and disadvantages.

Below, we would like to briefly explain the difference.

Placement above the muscle

With this technique, the implant is placed above the chest muscle and underneath the breast gland tissue.

Advantages include, but are not limited to:

• Less pain
• Hardly any movement of the implant when the chest muscle is contracted
• Only suitable when there is enough natural breast tissue. This technique is ideal for smaller implants, usually less than 250 ml.
• Suitable when a teardrop shape is desired.

Disadvantages include, but are not limited to:

• Sagging, especially with larger implants
• The implant may be more noticeable to the touch
• In some cases, visible rippling may occur

Important points:

• In slimmer patients, or when there is little natural breast tissue, the implant may be more visible or easier to feel.
• In some cases, the transition of the implant in the upper pole may be slightly more visible.

Placement below the muscle

With this technique, the implant is placed partially or fully underneath the chest muscle. When it is placed partially underneath the muscle, this is also called dual plane.

Advantages include, but are not limited to:

• Extra coverage of the implant, especially in patients with little natural breast tissue
• The implant is usually less visible or noticeable to the touch
• Can create a very beautiful and well-defined shape, especially in the cleavage area and the lower part of the breast
• Can provide a more predictable implant position in the long term
• Creates more cleavage because the implant sits in a higher position
• Recommended for larger implant volumes
• Also recommended when the skin is very elastic and therefore less suitable to support an implant on its own

Disadvantages include, but are not limited to:

• More pain during the first few days after surgery
• The implant may sometimes move when contracting the chest muscles
• In larger breasts, a waterfall effect may sometimes occur

Which technique is best?

There is no standard answer that is the same for everyone.

This depends on:

• your anatomy
• the quality of the skin and breast tissue
• your lifestyle and muscle activity
• the desired volume and result
• During the consultation, the doctor will assess together with you which technique is most suitable to achieve a beautiful, safe, and natural-looking result.