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A 39-year-old member asked:

Why are some breast implants placed behind the chest muscle and some placed in front of it?

5 doctor answers9 doctors weighed in
Dr. Vishnu Rumalla
Plastic Surgery 25 years experience
Implant position: Most board certified plastic surgeons would place implants under the muscle unless there is is a specific reason not to. In my practice these include: a competitve body builder who wants to work out their pectorals, a revision augmentation in someone who already has implants over the muscle and they are happy without wrippling or issue.
Dr. Azita Madjidi
Plastic Surgery 30 years experience
Many reasons: When an implant is placed behind the muscle, there is less risk of capsular contracture and in thin patients, the edges are better hidden. However the implants are usually held up by the muscle and do not drop into the lower breast. When an implant is put directly under the breast, there is greater risk of capsular contracture and in thin patients you can feel the edges.
Dr. Otto Placik
Plastic Surgery 34 years experience
Under or over?: Under the muscle implant placement generally produces a softer more natural lower profile breast with a lower rate of capsular contracture and improved mammograms. It is indicated in patients with particularly thin tissues. However it may have the disadvantage of greater amounts of surgery and distortion with muscular contraction. Over the muscle is less surgery with greater upper fullness.
Dr. Dennis Dass
Plastic Surgery 14 years experience
Patients' desires: This depends on the look you are going for. In most cases, implants are placed under the muscle, this produces a more natural appearance because there is more tissue to hide the implant. http://www.dassmd.com/breast-augmentation/los-angeles-breast-augmentation-under-the-muscle.html.
Dr. Tom Pousti
Specializes in Plastic Surgery
Surgeon's Preference: Generally, plastic surgeons will offer recommendations to patients about the best positioning of breast implants. In my opinion, there are many advantages ( that significantly outweighed the disadvantages) of placing breast implants in the sub muscular (dual plane) position. Patient should learn about the pros/cons of each approach and make educated decisions before proceeding.

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Last updated Apr 17, 2016

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