February 17, 2026 | Breast Surgery
5 minute read
An important yet misunderstood aspect of breast augmentation is where the implant will be placed. While implant size and type tend to get the spotlight in these conversations, implant placement plays a major role in how your breasts will look, feel, and age over time. This blog will discuss the differences between over-the-muscle and under-the-muscle breast augmentation to help you feel informed and confident when you head into your consultation.
Table of Contents
- What Is Breast Implant Placement?
- Over-the-Muscle Breast Implant Placement
- Under-the-Muscle Breast Implant Placement
- Internal Bra with GalaFLEX™
- Which Breast Implant Placement Is Right for You?
What Is Breast Implant Placement?
You have many options when it comes to customizing your breast augmentation. In addition to implant type (shape, size, material) and incision placement, implant placement is one such option. This refers to the implant’s position relative to the chest muscle (pectoralis major).
Two breast implant placements to choose from are:
- Over-the-muscle (subglandular) placement: The implant is placed above the chest muscle, beneath the breast tissue.
- Under-the-muscle (submuscular): The implant is placed partially or fully beneath the chest muscle.
This single aspect of your breast augmentation will affect breast shape and projection, the risk of visible rippling, how natural the breasts look and feel, your recovery experience, and long-term support and stability.
Dr. Elisa Burgess is a board-certified plastic surgeon who specializes in aesthetic and reconstructive breast surgeries. She offers patients up to date technologies—from visualization tools like Crisalix to help you imagine what your results might look like, ultrasound tech like Mindray High-Resolution Ultrasound to monitor your implants, and internal mesh bras to provide support during recovery from breast procedures.
If you’re considering breast augmentation, contact our office to learn more about the exciting options available to you!
Over-the-Muscle Breast Implant Placement
Over-the-muscle, or subglandular, implant placement positions the implant between the breast tissue and the chest muscle. This is likely what most people imagine when they think of a breast augmentation.
This approach may be ideal for patients who already have adequate natural breast tissue, want more pronounced cleavage, prefer a shorter recovery period, or engage in heavy chest workouts or athletics.
Benefits and Considerations
Advantages of subglandular implant placement include:
- Less post-operative discomfort
- A faster return to daily activities after recovery
- No muscle movement affecting the implant (animation deformity)
- A rounder, more augmented appearance
Subglandular placement may not be ideal for everyone, though. Potential drawbacks include:
- A higher risk of visible implant rippling in thinner patients or those with less natural breast tissue
- Less soft tissue coverage at the upper breast pole
- Increased reliance on skin quality for long-term support
This is where modern techniques, such as internal bra support, can make a meaningful difference—more on that later.
Under-the-Muscle Breast Implant Placement
Under-the-muscle, or submuscular, implant placement positions the implant beneath the pectoralis major muscle, either fully or partially (dual plane placement).
This placement is an excellent option for patients with less natural breast tissue who want a more natural-looking upper breast slope, who are concerned about implant visibility, or who prioritize long-term aesthetic stability.
Benefits and Considerations
Advantages of submuscular placement include:
- Better implant coverage and camouflage
- A lower risk of implant rippling
- A more gradual, natural breast contour
- Better visualization with mammograms
Submuscular placement offers excellent aesthetics and durable results, but it can involve:
- A longer recovery
- More initial tightness or soreness as the muscle heals
- Possible animation deformity (implant movement when flexing the chest)
Internal Bra with GalaFLEX™
For patients who want the benefits of over-the-muscle placement but are concerned about long-term support, GalaFLEX™ internal bra technology can be a game changer.
What Is GalaFLEX™?
GalaFLEX™ is a bioresorbable surgical mesh that acts as an internal bra when used for breast augmentation. It is not FDA approved for the breast but is FDA approved for soft tissue support. It reinforces the lower breast and supports the implant during healing. Over time, it stimulates your body’s own collagen production and is naturally absorbed.
When used strategically, GalaFLEX™ can:
- Provide added support for subglandular implants
- Reduce the risk of bottoming out or sagging
- Improve long-term breast shape and implant stability
- Support thinner skin or weaker tissue
Dr. Burgess may recommend an internal bra for patients with poor skin elasticity, larger implants, revision breast augmentation, or subglandular placement where added support is deemed beneficial.
This advanced option allows for more customization and expands who may be a candidate for certain implant placements.
Which Breast Implant Placement Is Right for You?
No matter which celebrity has a certain implant placement, or which option is getting more buzz on social media, there is no universal answer as to which placement option is “better.”
The best implant placement for you depends on a combination of factors, which may include:
- How much natural breast tissue you’re starting with
- Your chest wall anatomy
- Your skin quality
- Chosen implant size and type
- Your fitness level and lifestyle (are you a bodybuilder?)
- Your aesthetic preferences
- Your long-term goals
Dr. Burgess takes her time with patients during consultation. Together, you’ll discuss your unique needs and aesthetic goals, and Dr. Burgess will help guide you through all your options, from implant types to incisions and implant placement. With your vision and her guidance, you’ll be able to make decisions that will be beautiful in the long term.
Learn More About Breast Augmentation in Portland, OR
If you’re deep enough in your breast augmentation research to be thinking about implant placement, it’s time to schedule a personalized consultation! Dr. Elisa Burgess is a board-certified plastic surgeon known for exceptionally compassionate care and outstanding results. She and her friendly staff are ready to help you achieve your aesthetic goals.
To schedule your breast augmentation consultation at Burgess Plastic Surgery, please call (503) 699-6464 or use our online contact form.