How Do Surgeons Choose Breast Implant Placement for Different Patients?

Two patients considering similar breast implants may not necessarily have them positioned in the same way. Where an implant is placed in relation to the existing breast tissue and chest muscle depends on the individual patient rather than a single approach being suitable for everyone.

Breast implant placement determines which tissues will cover and support the implant. Understanding the differences between the available approaches can help you better understand why your surgeon may recommend one placement over another.

When May Above-Muscle Breast Implant Placement Be Considered?

Above-muscle placement positions the implant behind the breast tissue but in front of the pectoral muscle. This approach may be considered when the patient's natural breast tissue can provide sufficient coverage over the implant.

The available tissue needs to soften the transition between the implant and the surrounding breast. Where coverage is limited, the implant edges may be easier to see or feel, and rippling may become more noticeable. Assessing the amount and distribution of breast tissue therefore helps determine whether an above-muscle position is suitable for the individual patient.

When May Below-Muscle Breast Implant Placement Be Considered?

Below-muscle placement positions the implant at least partly beneath the pectoral muscle. It may provide additional implant coverage, while chest muscle involvement remains an important consideration.

When Is Additional Implant Coverage Needed?

Patients with relatively little natural breast tissue may have less soft tissue available to conceal the upper edge of an implant. Placing the implant beneath the pectoral muscle can provide another layer of coverage between the implant and skin.

This may help create a smoother transition from the chest wall into the augmented breast in selected patients. The need for additional coverage depends on the amount and distribution of natural breast tissue rather than body size alone, as patients with similar builds can still have different levels of tissue coverage.

How Can Chest Muscle Activity Affect the Decision?

Placing an implant beneath the pectoral muscle means that muscle contraction can affect the implant. In some patients, flexing the chest may temporarily alter the appearance or position of the breast, sometimes referred to as animation deformity.

How relevant this is may depend partly on how frequently or intensively the pectoral muscles are engaged during exercise or other activities. A surgeon may therefore consider muscle activity when weighing the benefit of additional coverage against the effects of placing the implant beneath an active muscle.

When May Dual-Plane Breast Implant Placement Be Considered?

Dual-plane placement positions the upper portion of the implant beneath the pectoral muscle, while the lower portion is not covered by the muscle in the same way. This creates a different relationship between the implant and breast tissues across the upper and lower breast.

This approach may be considered when the surgeon wants muscle coverage to soften the upper part of the implant, while allowing the lower breast tissue to sit over the implant more freely. This can help the surgeon shape the lower portion of the breast without relying on full muscle coverage throughout.

Dual-plane placement is not automatically preferable to above-muscle or below-muscle placement. It may be considered when this combination of upper coverage and lower tissue flexibility better matches the patient's breast anatomy and intended result.

Does the Breast Implant Itself Affect Where It Is Placed?

The implant itself forms part of placement planning, but choosing a particular implant brand does not automatically determine where it should sit. Its dimensions need to be compatible with the pocket that can be created for the patient.

When planning the implant pocket, relevant considerations may include:

• The width and projection of the implant need to work with the planned pocket and the available space within the breast.
• The amount of volume being added may influence how the implant can be accommodated within that pocket.

Find Out Which Breast Implant Placement May Suit You at SW1 Breast Clinic

You do not need to decide on a breast implant placement before your consultation. The purpose of surgical planning is to understand which approach may be appropriate for your anatomy and why it may be recommended for you.

At SW1 Breast Clinic, Dr Tan Ying Chien and Dr Wu Yijun assess breast implant placement as part of the overall augmentation plan, taking into account how the chosen approach may work with your existing breast tissues. Book a consultation to discuss the placement options that may be suitable for you.

FAQs About Breast Implant Placement

Does breast implant placement affect mammograms or breast imaging?

Breast implants can affect how breast tissue is viewed during mammography regardless of placement. Patients should inform the imaging facility that they have implants so appropriate imaging techniques can be used. The implant position may also be relevant when the radiographer plans the examination.

Can breast implant placement change over time?

The position of a breast implant can change over time as the surrounding tissues respond to ageing or weight changes. Implant displacement can also occur in some cases, which may require assessment if the breast develops a noticeable change in position or shape.

Can different breast implant placements be used for each breast?

In most cases, implant placement is planned to create an appropriate relationship between both breasts. However, existing asymmetry or differences in the breast tissues may occasionally require the surgeon to consider each side individually when developing the surgical plan.