Behind the Muscle, Behind the Breast - Which Is Best?

Posted Tuesday, July 6, 2010 to PROCEDURES > Breast

Posted by Kenrick Spence, M.D.; Board-Certified Plastic Surgeon

Breast enhancement with silicone and saline breast implants is a very popular procedure at my practice. Often patients ask, "Which is the best place for my implants - behind the muscle or behind the breast?"

The answer is that there are advantages to both and it is important that your surgeon evaluates your needs to determine which is best for you. For example, I prefer the partially behind the muscle technique (dual plane) for most of his patients but does utilize the behind the breast methods for patients that are bodybuilders. Patients with little breast tissue and thin skin benefit from behind-the-muscle placement as this provides a gentle slope off the chest wall creating a natural look. It also provides better implant coverage creating less risk of rippling.

Patients with thick skin and moderate breast tissue, who are bodybuilders, may have their implants placed behind the breast tissue. Placing implants in the submuscular position (behind the muscle) on a body builder who has a thick pectoralis muscle often exhibit a ridge across the breasts when the patient flexes.

There are other times when a subglandular implant (implant behind the breast tissue) works for a patient with a slight bit of droop. So for the patient with thick skin, very little breast droop, and significant amounts of breast tissue, an implant can be placed safely behind the breast tissue for a good long-term result.

Kenrick A. Spence, MD, FACS

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