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Breast implant placement positions

The most popular position for breast implants is below the muscle. Below the pectoral muscle is also more commonly referred to as ‘subpectoral’ or ‘submuscular’. Sub is a prefix for below. Using the muscle as the descriptive reference is better because the breast implants can be described simply as either above or below the muscle. The cross section below demonstrates the breast implant below the pectoral muslce after breast augmentation.

If a breast implant is placed above the pectoralis muscle is it called, ‘above the muscle’. Another way to describe this same anatomic position is in relation to the breast gland. When a breast implant is above the muscle, it is also placed below the breast gland and is called ‘below the gland’, or ‘subglandular’. In short, the sub prefix can be used to describe the two different positions, subglandular and submuscular.

Women may be confused by subtle descriptive terms that some plastic surgeons use. This is especially true of the submuscular positioning. Some plastic surgeons will add the term ‘partial’ submuscular. This adjective is actually more correct but in simplistic terms it is easiest just to remember the submuscular breast implant position means below the muscle. In essence nearly all submuscular breast implants are ‘technically’ only partially submuscular.

The degree of muscle coverage of the breast implant depends on the technique used for the woman breast augmentation. Partial muscle coverage means that the pectoral muscle has been ‘released’ or cut off the chest wall when creating the pocket for the breast implant and to create a more aesthetically pleasing breast shape. The degree or amount of release a muscle requires depends on the woman’s anatomy and breast enhancement desires. When no muscle release is performed the breast implant will usually remain in a higher position than a released muscle. Releasing the chest muscle allows the breast implant to settle to its lowest natural position along the inframammary fold. When the breast implant is at this position there is no muscle covering at the lowest points of the breast implant. This is where the term, partial submuscular coverage comes from. It also is used to describe the outer side aspect (armpit side) of the chest muscle and of the breast implant. If a large breast implant is used, the woman’s muscle will not cover this outer side of the breast implant, so again it is technically ‘partially’ covered submuscular breast implant.

When breast implants are placed above the muscle or subglandular, the only tissues covering the breast implants are the woman’s breast gland and skin. If the woman has minimal breast tissue or poor skin quality, the breast implants have a higher chance of being visible or palpable. So selecting the subglandular position for breast implants is typically not ideal unless the woman has lots of breast tissue and good skin characteristics.

Breast implants placed below the muscle or submuscular allows for an extra layer of natural tissue (muscle) to aide in covering the breast implants. It is important to remember that this extra layer of tissue does not guarantee that the breast implants will be completely covered. Breast implants, even below the muscle are only partially covered by this extra layer. The most common area of being able to feel the breast implants is along the outer side. This palpable edge occurs in both submuscular and subglandular breast implant positions. Overall, breast implants placed below the muscle provide better tissue coverage and longer lasting results with less skin stretch than the subglandular position.

The same relationships exist when a woman requests a breast lift with her breast augmentation.