Before making a final decision regarding breast augmentation, there are a number of questions you will want to ask the plastic surgeon.

During your consultation for breast augmentation, you should ask a number of important questions, including “where will the breast implants be placed?”

Many patients are unaware that they have a choice regarding the placement of breast implants. Implants may be placed either over or under the muscle, and several factors help determine the optimal implant placement for each patient, including:

Your body type
Your present condition
Actual volume (cc) of the implants.
Saline vs silicone implants
Your individual objectives and wishes
Board-certified and experienced plastic surgeons who have performed a large number of breast augmentation surgeries will be able to determine the optimal position for implant placement, and it is crucial for breast augmentation patients to understand the pros and cons of the two placement options.

Subglandular placement
The subglandular placement technique, also known as “over-the-muscle” placement, involves positioning the implant between the chest muscle and the existing breast tissue. The implant is positioned over the muscle so that it lies below the breast glands, thereby allowing the patient to breastfeed in the future.

Patients typically experience less implant movement during physical activity and less discomfort immediately following surgery.

CONS: The appearance may appear more synthetic. In addition, during mammograms the readings may be less accurate. Additionally, patients may experience a higher incidence of capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant contracts and squeezes it.

Submuscular placement
The other option is known as submuscular, or under-the-muscle placement of the breast implant. This technique includes placement of the implant partially under the pectoralis major chest muscle.

PROS: Patients experience more accurate mammograms. In addition, submuscular placement is associated with a more natural appearance and a lower incidence of capsular contracture.

Some patients experience slightly more discomfort and a longer recovery time after surgery.

The role of the chest muscle
In breast augmentation procedures, the chest muscles play an important role in the optimal placement of the implants. The amount of muscle in each patient will vary, and this could be a factor in determining whether subglandular or submuscular placement is optimal.

Each patient’s anatomy must be accounted for. For example, women with very large or strong chest muscles are ideal candidates for implants placed over the muscle. One reason for this is that with larger chest muscles, there is a tendency for the breasts to distort when the chest muscles are moved and flexed. In such instances, subglandular placement is recommended.

Quantity of breast tissue present
In addition to the muscle density and mass, the amount of tissue in the breast area before surgery will also have an impact on where the placement should be for optimal postsurgical results. When there is a substantial amount of breast tissue, there will be sufficient soft tissue coverage, rendering the pectoralis muscle unnecessary.

During the process of selecting a breast surgeon and the consultation for the procedure, you will want to discuss the placement of the breast implants, deciding whether over or under the muscle is the best option for you.