05/27/2026
Implants Above or Behind the muscle?
With breast augmentation, implants can be placed above (subfascial or subglabdular) or behind (dual plane) the muscle. I perform surgeries in both planes, it depends on the patient’s anatomy and preferences.
There are pros and cons to each plane - Above the muscle requires the patient to have sufficient “soft tissue coverage” or enough breast tissue to conceal/camouflage the implant , otherwise it can look round and unnatural. Some may consider “animation” a drawback to under the muscle breast augmentation, but usually this is something that is not commonly seen unless the patient is flexing their chest. In patients with minimal or thin breast tissue , behind the muscle still may be a better option in my opinion, so that the result looks natural.
With the use of a long-lasting numbing injection during surgery and a non-narcotic oral pain regimen, recovery and functional status is similar for me with either plane.
