Breast Implants FAQ’s – Breast Implants Under the Muscle or Over?

Sub Pectoral, Bi Planar or Sub Glandular Breast Implants?

Sub muscular Breast Implants Joel Studin Plastic Surgery
Sub glandular Breast Implants Joel Studin Plastic Surgery
Biplanar Breast Implants Joel Studin Plastic Surgery

Breast Implants Under The Muscle

In this picture, you can see that the pectorals muscle is completely surrounding the breast implant. These are breast implants under the muscle. All of the edges of the implant will be hidden, it will feel softer and there is extra support because the muscle acts as an internal brassiere. Sub muscular breast implant placement like this also is better for mammograms in the future. There is a layer of muscle between the breast gland and the implant.

Breast Implants Over The Muscle

In this picture, you can see that the pectorals muscle is completely BEHIND the breast implant. The edges of the implant are more likely to be visible and there is no extra support because the muscle is not acting as an internal brassiere. Sub muscular breast implant placement is not as good for mammograms in the future. The implant is in contact with the breast gland.

Breast Implants - BiPlanar

In this picture, you can see that while the  upper portion of the breast implant has been placed behind the pectorals muscle, the bottom of the muscle was cut in order to get there. Therefore, the lower portion is really a sub glandular breast implant. There is no extra support because the muscle brassiere has been cut on the bottom. It is not as good for mammograms in the future. It is certainly easier, but I don't think that it's the best way to do breast implants.

Pectoralis Muscle Joel Studin Plastic Surgery

The Pectoralis Major Muscle

The red muscle seen on the picture to the left shows why the Pectoralis Muscle is ideal for hiding and supporting your breast implants. It is in the perfect position.

How Sub Muscular  Breast Implants  Are Inserted

The easiest way to put implants beneath the muscle is to cut the bottom of the muscle and simply slide them underneath.  This is not ideal. This technique leads to biplanar breast implants, also known as partial sub muscular breast implants. With biplanar  breast implants, the lower portion of the breast implant is right against the breast gland. The muscle has been cut so  there is no internal bra and mammograms are more difficult.

In my opinion, the best way to do this is to avoid cutting this important muscle. The fibers of this muscle all run in one direction and can be clearly seen. It is possible to divide the muscle along the fibers, create the pocket under the fully intact muscle, and allow the muscle to snap back together over the implant.  While it is a little bit more involved, it is easily able to be accomplished with practice.

Why Do Sub Muscular Breast Implants Initially Ride High?

As you can see to the left, the pectoralis muscle is centered a bit higher than the breast. It has also always been right against your ribs. While it is an ideal internal brassiere, when the implant is first placed beneath it it is a little bit too supportive. That is why after surgery patients will not wear a brassiere until the muscle relaxes in the implant drops into perfect position. This can take a few months or even a year in some people.  Meanwhile, patients layer or wear loose clothing if they want to hide the fact that their breasts are riding a bit high. In clothing it doesn't look bad at all. It just looks like you are wearing a push-up bra.

It is certainly worth the wait though. Totally sub muscular breast implants  will look and feel like real breasts with normal healing.

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