Under the Muscle Breast Implants vs Over – Which Should You Go For? (Pros and Cons)

There are various important things you need to decide when you choose to have breast augmentation. For instance, you need to choose whether to have implants placed over the muscle or under the muscle.

Although our plastic surgeons will ultimately advise you which is best for your specific breasts (so take this post as information only), in the following post we are going to look at the subject in detail, discussing the pros and cons of each and answering some other important questions.

Is it better to get breast implants under the muscle or over?

It depends, placement is crucial though because the chest muscle can offer extra support for your breast implant and even affect the shape of your breasts if required.

Women who have smaller breasts often prefer to have the implant placed below the chest muscle. It is also recommended to have saline implants placed below your chest muscle.

Let’s look at this subject in a bit more detail though.

There are pros and cons about both so when trying to work out which is best when it comes to implant placement over vs under the muscle, it’s worth considering these.


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Under Muscle Breast Implant Placement Pros

Less Chance of Rippling

A common issue is wrinkles or folds in implants, known as rippling, which are noticeably visible through the skin and require an implant revision.

This issue occurs when there is a lack of natural breast tissue to cover over the implant, particularly if the patient has smaller than average breasts or is especially slim.

This can be avoided by opting for under breast implant placement.

Achieves natural breast contouring

Following nicely from above, with slim patients, under the breast placement also offers a more natural breast contour.

Although crucial when saline implants are involved, it is helpful for both saline and silicone implant options.


woman deciding on over vs under breast implants smiling


As saline breast implants contain sterile salt water, also known as saline, which is like the fluid naturally found in your body – if they are placed under the chest muscle, they’ll require some pressure to stop it from having too rounded an upper half.

Although most women nowadays opt for silicone implants, women with thin layers of breast tissue will mean the majority of silicone implants require under muscle placement.

You can read more about silicone vs saline vs gel breast implants <– in our in depth guide

Greater Amount of Breast Tissue is Scannable With a Mammogram

Which can help diagnose and identify breast cancer and other medical issues. It’s important to note that it is safe from a medical standpoint to place implants over or under the muscle.

Under Muscle Breast Implant Placement Cons

Some of the most common risks and concerns regarding under muscle placement includes:

Less Comfortable During The Recovery Period

While this is true, this is only a short-term problem that can be managed with prescribed medication that relaxes your muscles.

Implants Can Be Flattened or Distorted Whenever Your Chest Muscles Are Flexed

This is the number one reason why bodybuilders or women seriously interested in intensive weightlifting are recommended to have over muscle implants rather than under muscle.

Implant Can Be Displaced Over Time

Due to the constant pressure and force of the chest muscle on the breast implant, it can become displaced. This is especially the case when implants with smooth walls are used.


Over Muscle Breast Implant Placement Pros


breast implants selection on table


There is less discomfort and recovery are quicker

While this is a benefit, it is short-lived. Any decision you make about breast implant should be based on the more long-term benefits and results and whether you can avoid complications.

The Subfascial Pocket, Not the Sub glandular, Blunts the Edge of the Implant

The benefit of over muscle placement creates a natural contour

As Breasts Age And Descend Downward Naturally, The Implant Also Descends

This also helps to give implants a more natural look, for a longer period of time.

Will Give a Lift to Breasts of Patients With Naturally Sagging Breasts

When over muscle breast implant placement is opted for, it can help to avoid sagging of breasts in the future, especially if a pre-shaped implant is used.

Over the Muscle Placement Implants Don’t Flatten Out and Move When Muscles Are Flexed

This is referred to as distortion and movement but does not occur in over muscle placement.


Over Muscle Breast Implant Placement Cons


woman before under or over breast implants surgery


Less breast tissue is visible through a mammogram

Although a benefit, we’ve already noted that it is safe medically to have both over and under muscle placement.

Higher Risk of Capsular Contracture

Capsular contracture is particularly a risk if smooth surfaced breast implants are used

Can Increase Chance of Rippling If You Have Thin Breast Tissue

When there is a lack of natural breast tissue to cover implants, it increases the risk of the aforementioned ripples, or highly visible wrinkles or folds.

How long do breast implants under the muscle last?

With modern implants, there is very little difference between the lifespan of over muscle and under muscle implant placement.

Although it will depend on the individual, most women need to have their implants replaced, adjusted, or repaired after about years following breast augmentation, regardless of where they are placed.

Will under the muscle implants get bigger?

A common misconception many women have is that breast implants placed under the pectoralis major muscle will get bigger once they drop and settle.

The truth is that they won’t, implants don’t change size. They do however change size because you eventually lose the post-surgery inflammation and swelling.


If you are interested in breast augmentation, along with the many other things you may have already considered, you need to think about where your implants are going to be placed.

There is a lot of debate about whether implants being placed under or over the pectoralis muscle is best or not.

As we have hopefully shown, there are pros and cons to both and it depends on the surgeon, size of your breasts and your size in general.


Still Unsure? Book a Consultation Today With Our Experienced Plastic Surgeons For Customised-For-You Advice