Over the Pectoral Muscle vs. Under the Pectoral Muscle
New York City (NYC), Manhattan and all of New York (NY)
The last thing any woman wants is to have problems after breast augmentation surgery. That is why it is important to understand every aspect of the procedure before undergoing any operation.
In addition to the breast enlargement incision type, another important decision is where to place the implant. New York City breast surgeon Dr. Lefkovits will help you understand when you should elect over the pectoral muscle vs. under the pectoral muscle augmentation.
Supra Pectoral Placement (Over the Muscle)
This placement option is also known as sub-glandular, because it lies under the mammary gland but over the pectoral muscle, but that is somewhat a misnomer since all implants lie somewhere under the gland. Placement is better described in relation to the pectoral muscle.
Depending on your specific aesthetic desires and safety concerns, you may opt for over the muscle placement.
Pros
- More natural looking in some cases
- Easier surgical procedure
- Allows for larger size implants
Cons
- More interference during mammograms
- May be more visible
- High incidence of ripple appearance
- Greater chance of capsule contracture
- Increased possibility of bottoming out
Partial Sub Pectoral Placement (Under the Muscle)
A partial submuscular implant sits under just the front part of the pectoral muscle. The lower insertion point of the muscle is usually released, allowing the muscle to cover the implant.
Pros
- Still provides a natural look
- Reduces rippling effect
- Lowers risk of capsule contracture
Cons
- More discomfort after surgery
- Still a possibility of bottoming out since lower muscle insertion is released
- Higher chance of implant riding high
Full Sub or Under Pectoral Placement
The implant is inserted completely underneath the pectoral muscle and the lower muscle insertion point is left intact allowing the muscle to encompass the implant. Sub-muscular implants are performed through a trans-axillary incision.
Pros
- No implant visibility
- No rippling
- Low rate of capsular contracture
- Good internal support, sometimes providing bra-like support
Cons
- More difficult procedure
- Longer recovery time
- Pressure during exercise
Placement is just one of the many aspects to take into consideration when deciding on your breast enlargement surgery. Safety and aesthetic appearance are the primary concerns, but your body type and physical attributes may also dictate what type of placement will work best for you. It is important to discuss all the option with Dr. Lefkovits thoroughly prior to surgery.
Some of the other considerations for breast augmentation surgery include:
- Silicone gel or saline implants
- Breast enlargement incision type
- Size of the implant
Dr. Lefkovits is a New York City plastic surgeon trained in all aspects of breast augmentation surgery. Please contact the breast augmentation specialists at Park Plaza Plastic Surgery today to schedule an appointment to go over all the considerations of breast enlargement surgery.
Park Plaza Plastic Surgery
9 East 62nd Strre, New York, NY 10021

Dr. Lefkovits has been interviewed and featured in the Life & Style and the Globe magazines as well as numerous other publications.
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