Which Breast Implant Placement Provides the Most Natural-Looking Appearance?

implant placement for natural resultsDuring breast augmentation, implants can be positioned either above or below the chest wall muscle. Although both of these locations can be used to achieve successful outcomes for qualified patients, I find that placing breast implants underneath the muscle typically provides better, more natural-looking results for my patients, particularly in the long-run. Additional advantages of this implant position can include better visibility for detecting breast cancer during mammograms, as well as a decreased chance of capsular contracture. In fact, studies show that in the U.S., capsular contracture only occurs approximately 10% of the time when implants are placed under the muscle as opposed to 35% of the time in the above-muscle position.

When positioned above the muscle, the weight of breast implants (especially larger ones) often causes overlying skin tissues to stretch and thin with time. For many individuals, this may lead to noticeable shape asymmetries as well as a heightened risk of visible rippling on the skin due to a lack of soft tissue coverage. In addition, implants located in front of the muscle may produce a rounded appearance that is indicative of breast augmentation surgery.

Contrarily, when implants are placed below the chest wall muscle, there is generally superior short- and long-term support for the weight of each implant, greater soft tissue coverage, and a reduced risk of noticeable implant rippling – all of which can result in a more natural look and feel for the breasts.

Ultimately, there are pros and cons for both implant placement locations, and the details of each position can be thoroughly discussed during a consultation with a board certified plastic surgeon. At this time, the implant position that may be able to provide the most natural-looking results can be determined based on your unique needs and cosmetic desires.

Daniel C. Mills, MD, FACS

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