A common question among patients seeking breast augmentation is if the implants will be placed under the muscle or not. In the majority of patients, Dr. Rodgers prefers placing them underneath the muscle for added support and cosmetic appearance. Implants placed under the muscle also reduce the visual of “rippling” that is particularly common among women with little to no breast tissue. Depending on the size of an implant, they can be heavy, and the extra support of the muscle helps to prevent bottoming out of the implant. Bottoming out is when the implant falls below the inframammary fold (or the crease at the bottom of the breast) creating a low-lying implant and a high nipple. Studies have also shown that implants placed below the muscle have a lower incidence of capsular contracture. The body starts to form a capsule around every implant, most of the time this is a very thin layer of tissue that surrounds the implant. In certain cases, called capsular contracture; this layer becomes thickened and can create a hardened and uncomfortable breast. Placing implants under the muscle reduce both of these risks and reduce the need for possible surgery to correct them. 

Another common question among women of child-bearing age is whether they will be able to breastfeed or not following breast augmentation surgery. Placing the implants below the muscle preserve the natural breast tissue and allow women to have greater success breastfeeding as all the ducts remain in-tact. Preserved breast tissue also creates less interference with mammograms and makes it easier to detect breast cancer down the road. Patients who may go on to need a breast lift in the future can also benefit from placing the implants below the muscle as this better preserves blood flow to the skin and nipple. 

There are a few cases where Dr. Rodgers will recommend over the muscle placement of implants. This is common in patients with very strong chest muscles (i.e. body builders) where flexing of the muscles could cause distortion of the implants. Overall, it is best to have an in-person consultation to better understand all the benefits of placing implants under the muscle and to determine which procedure is best for you. Implants placed below the muscle have less complication rates, create a more natural augmented shape, and reduce the risk for future breast lift procedures down the road. 

By Kendall Peterson