Breast implants over the muscle vs. under the muscle

implants over the muscle and under the muscle

There are many questions to be asked when thinking about getting a breast augmentation. The size, shape, material and placement of the incision all come into play, but there is one big question on everyone’s lips. Should I get implants under or over the muscle?

The Pectoralis Major is a fairly large muscle that spans across the chest and inserts into the arm. Although a similar size, the Pectoralis Major make up the majority of the chest muscles in men, whilst subtly lie underneath the breasts in women.

So, getting back to the question, it means that breast implants can either be inserted partially underneath or on top of the Pectoralis Major, either by making an incision in the armpit, under the breast or around the areola.

Let’s highlight some pro’s and con’s.

Implants over the muscle:


  • If you have a sizeable Pectoralis Major (for e.g. a body builder), flexion of the muscle will not interfere with the overall shape of the implant.
  • A good option if you are getting a modest breast implant and have a reasonable amount of breast tissue to begin with. This results in a more natural looking breast.
  • Also a good option for women who used to have had larger breasts and no longer do, such as post breastfeeding mothers or those who have undergone substantial weight loss.
  • Implants can be placed slightly closer together than when inserted under the muscle.
  • Faster recovery.


  • Due to the implants sitting on top of the muscle, they can sometimes be quite round and pronounced. Some view this option as slightly less natural looking. But it is purely personal taste.
  • Less concealment of potential rippling, as there is generally not a great deal of tissue between the implant and the skin.

Implants partially under the muscle:


  • A good option for those with little to no breast tissue prior to the procedure.
  • Due to the implant being partially under the muscle, it is morphed into a natural teardrop shape under the subtle pressure from the Pectoralis Major, allowing a more natural looking breast.
  • Some radiologists have stated that mammography images are easier to accomplish when the implants are under the muscle, allowing a clearer picture. Not to say that a mammogram is not achievable with implants over the muscle. They simply may require a more thorough mammogram to ensure all tissue is correctly examined.


  • The procedure is viewed as slightly more ‘invasive’ due to the muscle disruption and increased recovery time.

As with all procedures in a variety of areas, Breast Augmentation is personalised to the individual. There’s not a single pair of pants that fit every woman, as there isn’t a single breast augmentation procedure that suits everyone.

It comes down to what you desire, what suits your frame and what is able to be achieved with the body you currently have. All will be thoroughly discussed during your consultation with Mr Ritz and together you will create an outcome that will have you feeling like all women should feel. Confident, comfortable and sexy.

Where do I begin?

Once you have had an initial consultation with Mr Ritz, we are able to give you a sneak preview of what’s in store by using our 3D Vectra Imaging machine. We take 3D photographs of you and are able to show you a 3D image of what you will look like post procedure with your desired breasts. This helps to alleviate any confusion about size, and also get you excited for the future, knowing that soon you will feel more comfortable in your own skin.

What should I expect from the surgery?

The surgery generally doesn’t take very long, usually only 1 hour. Though most patients stay in hospital overnight to recover.

Depending on what you do for work, you will need to take at least 2 weeks off, after which you may return to limited activity (or full activity if your job isn’t physically strenuous).

Directly after surgery you will be fairly tender. Soreness, swelling and bruising are very common and will dissipate over the coming weeks. A small incision scar will be noticeable, though will fade over time.

What happens after surgery?

The day following your procedure will see you popping back into our office to have the drain tubes removed. From there, you will be fitted with a special bra that you are required to wear day and night for 6 continuous weeks. Weekly check ups will occur until Mr Ritz gives you the all clear. Then, it’s goodbye to the special bra and hello to your new breasts.

A few important things to note

The implants are a foreign body, and although inserted by a professional will need to be changed after 10-15 years. If the procedure happens prior to family planning, there is no need to worry. Our breast augmentation does not affect a woman’s ability to breastfeed.

It is important to note that you will not be able to drive for the first two weeks post surgery. Physical activity and heavy lifting will be limited during the initial six week period of recovery. So stock up on your favourite films, a few cosy jumpers and coffee catch ups while you do those little odds and ends around the house that you’ve been putting off for so long.

Every woman deserves to love the body she is in. We take great pride in helping you achieve a body you are proud of, feel confident in and that is able to do everything you dream of doing.

To ask any further questions about the procedure and your particular case, give us a call on (03) 9508 9508 or visit the Melbourne Institute of Plastic Surgery.

Breast implants over the muscle vs. under the muscle