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The short answer to this question is that it depends … what follows are some of the factors that go in to making an informed decision on breast implant placement, specifically, whether it should be placed over or under the muscle.
For starters, the muscle being discussed if the pectoralis major muscle; put yours hands together and press and that is the muscle we are talking about (it is the same muscle used for planking or push ups).  If you decide upon a saline implant, the recommendation is to place the saline implant under the muscle the vast majority of the time.  Because the saline implant is easier to detect by sight and feel and the muscle offers additional coverage of the upper half or two thirds of the implant, saline implants are generally placed under the muscle.  Gel implants, because they are harder to detect, can go over or under the muscle.  With enough breast tissue of your own, for example about 2 centimeters thickness when pinching, the implant will be hard to detect.  So the question arrises, why go above the muscle?  There are several advantages in breast implant placement above the muscle; less pain, quicker recovery, a tendency to a more natural appearing result, an absence of implant distortion with muscle contraction in the short term and implant bottoming out in the long term.  Breast implant placement above the muscle does have its cons though; increased chance of seeing ripples and the possible need for additional imaging during mammography.  See below for a quick reference.

Above muscle

more risk of ripples
less pain
less recovery
implant does not move with muscle contraction
less risk of bottoming out
tends to more natural appearance
may need more views on mammogram
tendency to narrower cleavage

Below muscle

less risk of ripples
more pain
more recovery
implant moves with muscle contraction
more risk of bottoming out
tends to less natural appearance
less effect on mammogram
tendency to wider cleavage

The bottom line is that for the best recommendation schedule a consultation with board-certified plastic surgeon Dr. Nahai, and review the pros and cons in detail and help you make the best and most-informed decision.

Dr. Farzad R. Nahai’s approach to his patients is based on each individual’s needs and goals. He keeps up with the latest advancements in his field. He looks for and studies innovative surgical techniques and aesthetic treatments and works with his patients to find the safest and most effective solutions for their aesthetic needs. Dr. Nahai is a true artist who enjoys helping his patients feel and look their best.

Schedule a free consultation today with Dr. Nahai at The Center for Plastic Surgery at MetroDerm, P.C.. The center serves patients around the metro Atlanta, GA area including Dunwoody, Sandy Springs, Roswell, and Buckhead.

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