Above the Muscle vs. Below the Muscle Breast Implants: Which Is Right for You?
One of the most important decisions you’ll make during the breast augmentation process isn’t just choosing the size or type of implant—it’s deciding where the implant will be placed.
Many patients ask, “Should my breast implants go above the muscle or below the muscle?” The answer depends on your anatomy, lifestyle, aesthetic goals, and the recommendations of your plastic surgeon.
Understanding the differences between above-the-muscle and below-the-muscle breast implants can help you make an informed decision and achieve the most natural-looking results possible.
What Does “Above the Muscle” Mean?
Above-the-muscle breast implants, also known as subglandular implants, are placed between the breast tissue and the chest muscle.
In this position, the implant sits directly behind the natural breast tissue without being covered by the pectoral muscle.
Benefits of Above-the-Muscle Implants
Shorter surgery time
Potentially quicker recovery
Less discomfort immediately after surgery
No animation deformity (implant movement during chest muscle contraction)
Can create more fullness in the upper portion of the breast
Considerations
Because there is less tissue covering the implant, above-the-muscle placement may increase the visibility of implant edges or rippling, particularly in thinner patients with limited natural breast tissue.
For this reason, not every patient is an ideal candidate for subglandular placement.
What Does “Below the Muscle” Mean?
Below-the-muscle breast implants, also known as submuscular implants, are placed partially beneath the pectoralis major muscle.
Today, most breast augmentations performed in the United States utilize some form of partial muscle coverage because it often provides a more natural transition between the chest and the implant.
Benefits of Below-the-Muscle Implants
More natural appearance in many patients
Increased soft tissue coverage
Reduced visibility of implant edges
Lower risk of visible rippling
Often preferred for patients with minimal natural breast tissue
For women who are naturally thin or starting with a smaller breast volume, submuscular placement can provide a smoother, more natural contour.
Considerations
Patients may experience slightly more discomfort during the initial recovery period because the chest muscle is involved in the procedure.
In some cases, patients may notice mild implant movement when flexing their chest muscles, known as animation deformity.
Which Implant Placement Looks More Natural?
One of the biggest concerns patients have is achieving natural-looking breast augmentation results.
For many women, below-the-muscle placement provides the most natural appearance because the muscle helps soften the upper portion of the implant.
However, this does not mean below-the-muscle placement is always the best choice.
Women with adequate natural breast tissue may achieve beautiful, natural-looking results with above-the-muscle implants as well.
The ideal approach depends on your unique anatomy rather than a one-size-fits-all recommendation.
Which Placement Is Better for Active Patients?
Patients who regularly participate in weightlifting, CrossFit, bodybuilding, tennis, swimming, or other upper-body intensive activities often ask whether implant placement will affect performance.
In some cases, highly active patients may prefer above-the-muscle placement because the implant is not affected by pectoral muscle contractions.
However, many athletic women successfully undergo below-the-muscle augmentation without any limitations after recovery.
This is an important discussion to have during your consultation with your plastic surgeon.
Which Placement Has a Faster Recovery?
Recovery experiences vary from patient to patient, but generally:
Above-the-Muscle Recovery
Less chest muscle involvement
Potentially less discomfort
Faster return to certain activities
Below-the-Muscle Recovery
Slightly more soreness initially
Tightness across the chest during early healing
Recovery may take a bit longer during the first few weeks
Most patients return to normal daily activities relatively quickly regardless of implant placement.
How Does Your Body Type Influence Implant Placement?
Your surgeon will evaluate several factors when recommending implant placement, including:
Amount of existing breast tissue
Skin quality and elasticity
Chest wall anatomy
Desired implant size
Lifestyle and exercise habits
Cosmetic goals
Patients with very little natural breast tissue often benefit from additional implant coverage provided by the chest muscle.
Patients with more existing breast volume may have greater flexibility when choosing implant placement.
Is One Option Safer Than the Other?
Both above-the-muscle and below-the-muscle breast implants have excellent safety profiles when performed by an experienced, board-certified plastic surgeon.
Rather than focusing on which option is “safer,” the goal is determining which placement will provide the best long-term aesthetic outcome for your specific anatomy.
A personalized surgical plan is one of the most important factors in achieving successful breast augmentation results.
Frequently Asked Questions
Are above-the-muscle implants more noticeable?
They can be in some patients, particularly those with minimal natural breast tissue. Patients with adequate breast tissue may still achieve natural-looking results.
Do below-the-muscle implants look more natural?
In many cases, yes. The muscle provides additional coverage that can help soften the appearance of the implant.
Which breast implant placement hurts more?
Below-the-muscle placement may involve slightly more discomfort during the first few weeks because the chest muscle is affected during surgery.
Can athletes get below-the-muscle implants?
Absolutely. Many athletes choose below-the-muscle implants and return to their regular activities after recovery.
Which breast implant placement lasts longer?
Longevity is generally related to the implant itself rather than the placement location. Both options can provide long-lasting results.
Schedule a Breast Augmentation Consultation
Choosing between above-the-muscle and below-the-muscle breast implants is a highly individualized decision. The best implant placement depends on your anatomy, lifestyle, and aesthetic goals.
During your consultation, Dr. Robert Rothfield will perform a thorough evaluation, discuss your options, and recommend the implant placement that will help you achieve beautiful, natural-looking results.
If you’re considering breast augmentation and would like to learn more about your implant placement options, contact Weston Plastic Surgery to schedule a consultation today.