Breast Implants: Over vs Under Muscle

 In Breast Augmentation

One of the things you and your Toronto plastic surgeon will have to decide when you opt for a breast augmentation, is whether the implant will go over or under the muscle. An over muscle implant is inserted beneath the breast tissue and on top of your chest muscles, while an under muscle implant goes under the chest muscles.

How muscle affects implants


Placing an implant under the muscle helps to give it a more natural look, particularly if you have very little natural breast tissue to cover it up. This placement is also often chosen with saline implants because the muscle tissue squeezes down on the implant helping to make the upper portion of the breast have a naturally sloping appearance.

Of course, this can also be achieved by choosing a tear-drop shaped implant, an option that often works well in post-mastectomy reconstructive surgery.

Sometimes, over muscle implants can actually look more natural. That’s because when the chest muscle contracts, it presses down on an under-muscle implant, changing its shape. Women with a very active lifestyle would usually be advised to go for an over muscle implant to overcome this effect.

When doctors recommend an over muscle implant

More often than not, we will recommend an over muscle implant if you already have a fair amount of breast tissue – a B-cup breast is sufficient to cover an over-muscle implant nicely. Of course, silicone implants would be the usual choice too, and the amount of breast augmentation also comes into play.

Most women who are recommended an over muscle implant can also opt for an under muscle implant if they prefer, but this doesn’t necessarily work the other way around. Under muscle implants would be recommended if over muscle implants won’t look as natural, and ultimately, that’s what patients want: a natural look that isn’t obviously an implant.

Debunking a few myths

Many women come to their consultation with a few misconceptions that are understandable. They may think that by having the implant placed under the muscle, there’s less chance of sagging, but that’s not true. Implants remain where they’ve been placed, but the soft tissue of the breast may sag over time regardless of whether the implant was placed over or under the muscle.
Some think that the deeper the implant is placed, the less likely it will be to rupture. Again, that isn’t strictly true. Most implant ruptures aren’t the result of accidents, they happen because the outer shell of the implant naturally wears down over time.
Other patients tell us they’ve heard that implant placement will affect the clarity of their mammogram, and there are radiologist who maintain that his is true. However, there are also those who say that over or under muscle placement doesn’t make any difference at all.

Let us talk you through your options

The best way to decide whether over or under muscle placement will work for you is to come for a consultation. Your doctor will talk you through your options and give you all the first-hand information you need to make an informed decision.