Do breast implants go over or under the muscle?


One of the most common questions that people ask when considering and researching breast surgery is – do the implants go over or under the muscle. Whilst there is no single ‘correct’ answer – they are both possibilities with their own separate pros and cons.

One of the more common procedures in cosmetic surgery when enlarging the breasts is to place the implants under (behind) the muscle (aka pectoralis major). The main stand-out reason for this being is that feedback from radiologists has shown that it is easier to screen for breast cancer if the implants are sub-pectoral – under the muscle, compared with pre-pecotral – over the muscle.

Breast cancer screening

When looking to the future, this is one of the more serious questions you need to ask yourself as every medical professional will tell you to take breast cancer seriously. Whilst breast cancer screening is not a guarantee, nor a perfect way of screening, it is proven very successful in checking for cancer of the breast. So whilst you may only be 20-30 now, when you get to the age of 50 you will be invited to regular breast screening clinics as the chance of breast cancer is higher in the 50-70 age bracket.

A natural look and feel

Other advantages of opting for breast implants to be placed behind the muscle is to achieve a more natural look and feel. Implants that are placed in front of the muscle tend to look more unnatural in profile. Whereas under the muscle implants can look smoother and more contoured as the muscle itself flattens the breast against the body for a more streamlined appearance.

One of the fears with breast implants is the rippling effect. When more procedures were carried out using saline filled implants, the fear was that they could ripple as the type of implant was more prone to rippling and creating an unnatural look. That is why placing saline implants behind the muscle was preferred. It is however noted that in more modern times women are opting for silicone implants – which in themselves are more smooth, natural and less likely to ripple. Tissues also tend to drape over the silicone implants more easily also. Therefore, if opting for silicone implants – they can be placed in front of or behind the muscle and still look and feel the same.

Longer recovery time

On the flip side, as with all procedures there are risks involved. As mentioned earlier there are pros and cons to each decision of where to place implants. So now we will talk about the cons, or disadvantages. Placing the implant under the muscle can sometimes be more painful and the recovery time may be longer – sometimes requiring more aftercare. Another possible negative point for behind the muscle placement is that it may be possible to see a visible contraction of the muscle around the breast implant during activity or sports. Also, as the position of the implant is slightly higher when inserted below the muscle it can look less natural in sagging breasts. Furthermore, breast surgery may require a combination of enlargement and uplift in breasts are already ‘saggy’.


Each and every woman has a different set of preferences when it comes to breast enlargement and no one has the same experience. What works for one female, may not work for another. That is why it is very important to have consultations with specialists who will be able to provide advice and information on what is best for you, your goals and your shape. For example, although over the breast implants boasts a shorter average recovery time – this may not be factor for you personally. On the other hand, it is often found that thinner women with little breast tissue to cover the implant prefer under the muscle procedures. Lastly; other points to take in to consideration when thinking about under or over the muscle are: how droopy are your breasts at the moment, do you want a softer – more natural draping, and chances of developing capsular contracture. what is capsular contracture? Capsular contracture is a natural response of the body’s immune system to foreign objects – such as a pacemaker or breast implant. It is a medical complication that may make the breast implant look displaced.