I am Dr. Perfect Celebrity, a board-certified plastic surgeon in Dubai. A common inquiry that my practice receives is whether breast implants should be placed over or under the muscle. The answer is that it depends. In the majority of cases, we will place the implants underneath the pectoralis major muscle, which covers the upper two-thirds of the implant. This is crucial for reducing the risk of capsular contracture and rippling in the medial portion of the breast that is most visible. In the 1970s and 1980s, it was possible to place breast implants on top of the muscle for specific reasons. However, in the vast majority of patients, it is recommended that the implants be placed under the pectoralis major muscle.
Before the Muscle In the early days of breast augmentation all implants were placed in front of the muscle, called a “sub-fascial” placement. But as surgical techniques improved, doctors began placing implants behind the muscle for some select patients. Occasionally I will place the implant in front of the chest muscle in women with a moderate amount of breast tissue. This placement usually results in a shorter recovery and can reduce the risk of changes in the shape of the breast after surgery. However, women with minimal existing breast tissue are more prone to visual rippling or wrinkling with subfascial placement. This is because the tissue does not cover the implant sufficiently and the results appear unnatural. Under the muscle, I like to place the implant behind the muscle for a more natural look. Sub-pectoral muscle implants are also said by many board certified surgeons to be better supported and to result in less sagging. For women with very little natural breast tissue, I generally recommend the sub-muscular placement of the implants. The more “padding” you have in front of the implant, the less likely you will see rippling. This position does involve a slightly longer healing period, but may help to lower the risk of capsular contracture. Capsular contracture is when scar tissue forms tightly around the implant, which can cause it to be deformed and painful. For women who choose anatomically shaped implants, placing them under the muscle is also a common choice, because the muscle prevents the implants from rotating within the pockets. These teardrop implants look natural and the best results are obtained when they are placed in the correct orientation.
And implants placed under the muscle are easier to see on mammograms. This may be particularly relevant to women with a family history of breast cancer. I myself prefer to place the implants under the pectoralis major muscle but there are situations and patient preferences that may dictate the need for alternative implant placement.
Implants In Dubai
Implants in Dubai is a surgical procedure that improves breast size, shape, and symmetry by using carefully chosen implants. The placement of the implants above or below the muscle is determined by your anatomy, existing breast tissue, and aesthetic goals. A personalized surgical plan can help you achieve natural-looking, balanced, and long-lasting breast augmentation results.
Understanding Implant Placement
Breast implants can typically be placed in one of two positions.
Above the muscle (subglandular placement): The implant is placed beneath the breast tissue, but above the pectoralis major muscle.
Below the muscle (Submuscular or Dual Plane Placement): The implant is partially or completely beneath the chest muscle, depending on the surgical technique.
Each placement provides distinct benefits and is appropriate for a variety of patients.
What Is Above-Muscle Implant Placement?
In above-the-muscle placement, the implant is directly behind the natural breast tissue, not covered by the chest muscle. This approach has been used successfully for many years and is still an excellent choice for certain patients.
Because the implant is not placed beneath muscle tissue, surgery may be less invasive and recovery more comfortable. Patients with naturally thicker breast tissue frequently achieve excellent cosmetic results with this technique because the existing tissue provides adequate coverage for the implant.
BOOK AN APPOINTMENT TODAY
Advantages Of Above-The-Muscle Placement: Faster Recovery
Because the chest muscle is not lifted during surgery, patients often have less muscle soreness and can return to normal activities sooner.
Improved Implant Projection
Implants placed above the muscle can provide more upper-pole volume, making them a popular choice for patients looking for a rounder breast shape.
Less Movement During Exercise
Because the implant is not beneath the pectoral muscle, it remains more stable during chest muscle-related activities. Athletes and bodybuilders may prefer this position for this reason.
Simplified Surgical Procedure
Above-the-muscle placement generally requires less manipulation of muscle tissue, potentially shortening the operative time and alleviating postoperative discomfort.
Considerations For Above-The-Muscle Placement
Although this technique has numerous advantages, it may not be suitable for everyone.
Patients with very little natural breast tissue may have:
- Improved visibility of implant edges.
- More noticeable implant rippling.
- A less natural-looking upper breast contour
- Higher chances of feeling the implant through the skin.
Careful patient selection is required to achieve appealing, natural results.
What Is Below-The-Muscle Implant Placement?
Below-the-muscle placement entails placing the implant beneath the pectoralis major muscle. Today, many surgeons use a dual-plane technique, in which the upper portion of the implant is covered by muscle and the lower portion is hidden beneath breast tissue.
This method combines the benefits of both implant positions and has become one of the most popular breast augmentation procedures.
Benefits Of Below-The-Muscle Placement
More Natural Appearance
The additional muscle coverage softens the transition between the chest wall and implant, resulting in a more natural breast contour.
Better Implant Coverage
Patients with little breast tissue benefit from the muscle covering the implant, which minimizes visible edges and rippling.
Lower Risk Of Capsular Contracture
According to research, implants placed beneath the muscle may reduce the risk of developing capsular contracture, a condition in which scar tissue tightens around the implant.
Improved Mammography
Submuscular implants typically interfere less with breast imaging, allowing for better visualization of natural breast tissue during mammograms.
Long-term Cosmetic Benefits
Many patients have more stable long-term results because muscle support helps to keep the implant in position.
Considerations For Below-The-Muscle Placement
While below-the-muscle placement is popular, there are some things to consider.
Longer Recovery
Patients may experience more muscle soreness in the first few weeks because the chest muscle was elevated during surgery.
Temporary Muscle Tightness
Chest tightness is common in the early stages of healing, but it gradually improves.
Implant Movement
Some patients notice slight implant movement when they contract their chest muscles forcefully. This is generally harmless, but it may be noticeable in athletes who engage in strenuous upper-body workouts.
What Is Dual Plane Breast Augmentation?
Many surgeons believe that dual plane placement achieves the best balance of aesthetics and support.
Using this technique:
- The upper implant remains covered by muscle.
- The lower implant expands naturally underneath the breast tissue.
This enables patients to achieve:
- Improved upper breast coverage.
- Natural lower breast fullness
- Improved breast shape.
- Reduced implant visibility
- Excellent long-term positioning.
For many patients, dual plane placement combines the benefits of both traditional approaches.
Which Placement Appears More Natural?
Because the muscle softens implant edges, below-the-muscle or dual-plane placement typically results in the most natural appearance for patients with minimal breast tissue.
Patients with adequate natural breast tissue frequently achieve equally beautiful results with above-the-muscle placement.
Finally, natural-looking outcomes are more dependent on careful surgical planning than on implant placement alone.
Which Place Has A Faster Recovery?
Above-the-muscle placement typically allows:
- Reduced muscle discomfort.
- Faster arm movement.
- Early return to light activities
- Reduced chest tightness.
Because of muscle involvement, below-the-muscle placement may take slightly longer to heal, but most patients recover within a few weeks.
Which Placement Is Best For Thin Patients?
Patients with little breast tissue typically benefit from below-the-muscle placement because the extra muscle coverage helps conceal the implant.
This often leads to:
- Softer breast contours.
- Less visible implant edges.
- Reduced rippling
- More natural movement.
Which Placement Is Best For Athletic Patients?
The answer depends on the individual’s training regimen.
Some athletes prefer above-the-muscle placement because it reduces implant movement during chest muscle contractions.
Others prefer a more natural appearance of submuscular placement, despite minor movement during strenuous exercise.
An experienced plastic surgeon carefully considers lifestyle factors before making recommendations.
Does Implant Placement Affect Breastfeeding?
Most women can continue to breastfeed after breast augmentation, regardless of implant placement.
The ability to breastfeed relies more on:
- Surgical incision site
- Preserving milk ducts
- Individual Anatomy
- Future pregnancies.
Patients planning future pregnancies should discuss their breastfeeding goals during consultation.
MEET THE EXPERT DOCTOR
Does Implant Placement Affect Mammograms?
Modern mammography techniques can assess breasts with implants regardless of placement.
However, implants beneath the muscle generally allow radiologists to see more natural breast tissue, making routine screening a little easier.
Patients should always inform imaging centers that they have breast implants before having mammograms.
Does Implant Placement Affect Implant Longevity?
Instead of just placement, implant lifespan is determined by a variety of factors such as implant quality, patient anatomy, lifestyle, and natural ageing.
When performed by an experienced plastic surgeon and followed up on regularly, both above-the-muscle and below-the-muscle implants can provide excellent long-term results.
Best Plastic Surgeon In Dubai For Implants
Best Plastic Surgeon in Dubai for implants is available at the Perfect Doctors Clinic, where Dr. Perfect Celebrity carefully determines whether implants should be placed above or below the muscle based on your anatomy, lifestyle, and aesthetic goals. His personalized approach ensures natural-looking results, long-term outcomes, increased comfort, and beautifully balanced breast contours.