Breast Implant Placement FAQs

Should your new breast implants go over the muscle or under it? Can you go braless? How will breast implant placement affect your exercise routine? These and all your other questions about breast implant placement are answered below.

 

  1. What are my breast implant placement options?
  2. Should my implants be placed over or under the chest muscle?
  3. What is the difference between breast implants placed over the pectoralis muscle and those placed underneath it?
  4. When should you place the breast implants behind the muscle?
  5. Can I have breast implants placed behind the muscle with a transumbilical (TUBA) insertion?
  6. Can I work out my chest muscles if my implants are placed underneath them?
  7. Can I go braless if my implants are placed under the muscle?
  8. Does the rate of capsular contracture vary with implant placement?
  9. Can I change my implant placement with revision breast augmentation surgery?
  10. Is symmastia and displacement more common among active people with under-the-muscle breast implants?
  11. How long does it take for breast implants to drop with under-the-muscle placement?
  12. Which breast implant placement best masks rippling?
  13. Does implant placement affect breast cancer detection?

1. What are my breast implant placement options?

In general, breast implants can be placed directly under your natural breast tissue (subglandular or over-the-muscle placement), under your pectoral muscles (submuscular or under-the-muscle placement) or behind your breast tissue and partially under the pectoral and other chest muscles (partial submuscular implant placement).

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2. Should my implants be placed over or under the chest muscle?

This decision should be made with your surgeon based on your anatomy and your preferences. There are advantages and disadvantages to both. If you have very small breasts and relatively thin skin, you may need to go under the chest muscle because this will provide more padding between the implant and the skin, and provide a better cosmetic result.

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3. What is the difference between breast implants placed over the pectoralis muscle and those placed underneath it?

If your implants are placed over the muscle, the top edge of the implant will be visible, producing a distinct cleavage line that extends up around the top of the breast. If your implants are placed underneath the muscle, the upper edge of the implant will be less distinct.

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4. When should you place the breast implants behind the muscle?

If you are extremely small breasted, the muscle may be needed to help cover the breast implant. If you want to go to a large size (full D cup or larger) and have thin skin and little subcutaneous tissue, the muscle is needed to cover the implant.

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5. Can I have breast implants placed behind the muscle with a transumbilical (TUBA) insertion?

Yes, you can have breast implants placed partially underneath the pectoralis major muscle with the TUBA technique. During TUBA, a short J- or C-shaped incision is made within your belly button and empty saline breast implants are moved into place using endoscopy, a procedure in which the surgeon uses a tiny fiber-optic camera to view the interior of the breast.

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6. Can I work out my chest muscles if my implants are placed underneath them?

Yes you can, but it is important to get clearance from your surgeon before you begin exercising after breast implant surgery.

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7. Can I go braless if my implants are placed under the muscle?

Technically, yes, you can go braless if you choose, but your breasts will need support regardless of the implant placement. Without proper support, breast sagging may occur.

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8. Does the rate of capsular contracture vary with implant placement?

It depends who you ask. Some surgeons believe that the incidence of capsular contracture can be reduced if the breast implants are placed under the muscle because of the constant massage that the implant receives from the muscles. The truth is that capsular contracture is unpredictable and can occur with any type of implant placement.

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9. Can I change my implant placement with revision breast augmentation surgery?

Yes, but if you switch to an under-the-muscle implant from an over-the-muscle implant, expect more discomfort than during your previous surgery.

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10. Is symmastia and displacement more common among active people with under-the-muscle breast implants?

Your activity level and the placement of your implants will not affect your risk of synmastia, a condition which occurs when the two breast implants touch in the middle of your chest. This can happen if your breast implants are too large, or if there is too much loosening of the muscles at the breast bone (over-dissection). Revision breast augmentation may be needed if you develop synmastia implant displacement, among other reasons.

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11. How long does it take for breast implants to drop with under-the-muscle placement?

Your breast implants should drop slightly within a few weeks or months of your surgery. This varies based on several factors, including your breast implant size, its surface and your muscle tone. That said, implants that are placed over the chest muscles may drop sooner than those placed underneath the muscle. Some surgeons may suggest that you use a strap that is wrapped around your upper chest, under your arms and over the top half of your breasts to encourage dropping. Massage can also help. Talk to your surgeon.

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12. Which breast implant placement best masks rippling?

Implant placement does not necessarily affect your risk of visible or palpable rippling or wrinkling of your implants. Rippling may be more common or obvious with saline-filled implants or in women with thin breast tissue. Discuss your personal risk factors with your surgeon.

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13. Does implant placement affect breast cancer detection?

In general, breast implants can obscure the mammogram or breast X-ray images, which may interfere with the detection of breast cancer. Protect yourself by asking for a referral to a clinic where radiologists have experience reading mammograms of women with breast implants. Make sure to tell the staff members that you have breast implants. Under-the-muscle placement of breast implants may be less likely to obscure your mammogram than above-the-muscle placement. Read about this important subject in the Mammograms and More Section. A diagnosis of breast cancer would require breast implant removal.

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    Ronald H. Schuster, MD

    10807 Falls Road, #100
    Baltimore, MD 21093
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    Brian R Buinewicz MD

    Buinewicz Plastic Surgery & Medspa
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    Doylestown, PA 18902
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    Julio Clavijo-Alvarez, MD

    Re-Nova Plastic Surgery
    1000 Stonewood Drive
    Suite 320
    Wexford, PA 15090
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