Above Or Below The Muscle: Which Breast Augmentation Is Right For Me?

When it comes to having a breast augmentation there are two options: saline vs silicone.  There are also options as to where the implants can be placed.

If saline implants are used the only option is for placement behind the muscle.  Saline implants, if not placed behind the muscle, have a tendency to show rippling under the skin.

If you choose to have silicone implants, then you have the option of placing them behind or in front of the muscle.  Placing the implant in front of the muscle has many advantages.  In my eyes, it makes more sense to place the implant in front of the muscle, since this is naturally where breast tissue is found.  I feel that a much more natural look can be achieved this way as well.  The postoperative pain is usually less than that if placed behind the muscle.

It also avoids what is called “dynamic deformity”.  This occurs in breast augmentations that are placed behind the muscle.  When the pectoralis muscles contract they move the implants upward and laterally.  There is still debate on whether the capsule that forms around all implants is more or less likely to get thick and be an issue down the road depending on whether the implant is placed in front of or behind the muscle.

I feel that the benefits of placing the implants in front of the muscle in breast augmentations with silicone implants far out weight those for placing them behind the muscle.  Most patients are good candidates for this as long as they have at least  “A”cup size natural breasts.