South Florida Center for Cosmetic Surgery

One of the most important decisions you’ll make during your breast augmentation journey—aside from implant size and type—is implant placement. This refers to where your plastic surgeon positions the implant in relation to your chest muscle and breast tissue. The placement affects not only your final look and feel but also your recovery, risk of complications, and long-term satisfaction.

There are several placement options to consider, including submuscular, subglandular, subfascial, and dual plane. Each has distinct advantages and potential limitations. The right choice depends on your anatomy, lifestyle, and aesthetic goals.

In this blog, we’ll break down each option and help you understand how the placement decision plays a vital role in your breast augmentation outcome.

Breast implant placement refers to the anatomical position of the implant in your chest. Surgeons can insert implants either:

• Below the breast tissue only (subglandular),
• Under the chest muscle (submuscular),
• Beneath the fascia layer of the muscle (subfascial), or
• Partially under the muscle and partially under breast tissue (dual plane).

Each option offers different visual effects and healing processes—and your surgeon will recommend a placement based on your existing breast tissue, muscle structure, skin quality, and desired look.

What It Is:

In submuscular placement, the implant is positioned beneath the pectoralis major muscle, offering more upper pole coverage for the implant. This technique is popular for many different patients.

Pros:

• Reduces visible implant rippling
• Provides a more natural slope in the upper breast
• Lower risk of capsular contracture
• Implants age more naturally over time

Cons:

• Slightly longer recovery time due to muscle healing
• Risk of “animation deformity” (movement of implant with chest flexing)
• May not be ideal for highly athletic individuals

What It Is:

In this approach, the implant is placed directly beneath the breast tissue but above the chest muscle. It can create a fuller, rounder appearance—especially in the upper breast.

Pros:

• Faster recovery and less post-op discomfort
• No interference with muscle activity
• Better cleavage and upper pole volume in some cases

Cons:

• Higher risk of visible rippling or implant edges (especially in thin patients)
• Increased risk of capsular contracture
• May not provide long-term support, especially with larger implants

What It Is:

Subfascial placement involves positioning the implant beneath the fascia, the thin connective tissue layer overlying the chest muscle—but not under the muscle itself.

Pros:

• Offers additional coverage and support without full muscle disruption
• Reduced rippling compared to subglandular placement
• Less animation deformity than submuscular placement

Cons:

• May not provide as much implant support in the long term
• Technique-sensitive, and not all surgeons prefer it
• Not as widely studied or adopted as other methods

What It Is:

Dual plane placement is a hybrid technique that allows the upper portion of the implant to sit beneath the muscle while the lower portion is beneath the breast tissue. It’s often recommended for patients with mild breast ptosis (sagging) or thin breast tissue.

Pros:

• Natural upper slope with fuller lower pole
• Good for patients needing mild lift without additional surgery
• Versatile and highly customizable

Cons:

• More complex surgical technique
• Slightly longer recovery
• Not suitable for all body types

Your plastic surgeon will evaluate several key factors before recommending a placement strategy:

• Amount of natural breast tissue
• Skin elasticity
• Chest wall shape
• Activity level or athletic lifestyle
• Desired fullness or natural slope
• Previous surgeries or scarring

Some patients may even undergo implant revision surgery years later to switch planes for better support or improved aesthetics.

Breast implant placement can also influence how your results age over time. For instance:

• Submuscular placement may hold its shape longer as the muscle supports the implant.
• Subglandular placement may sag more quickly, as it follows the natural aging of the breast tissue.
• Dual plane placement offers a middle ground and is ideal for many patients with slight natural sagging.

Over time, life events like pregnancy, weight fluctuations, and aging can impact implant position, so understanding how placement plays into longevity is key.

In some cases, patients may need revision surgery to improve outcomes, correct asymmetries, or resolve complications like capsular contracture. Common revision adjustments include:

• Switching from subglandular to submuscular for better coverage
• Repositioning the implant due to bottoming out or migration
• Converting to a dual plane approach for improved contour

Your surgeon will factor in your original placement, current anatomy, and aesthetic goals when planning any future updates.

When it comes to breast implant placement, there’s no universal “best” method—only what’s best for you. Each option—whether it’s submuscular, subglandular, subfascial, or dual plane—offers unique benefits and trade-offs depending on your body composition, skin quality, activity level, and cosmetic goals.

For instance, submuscular implants may offer longer-lasting results with reduced rippling but come with a more intense recovery and potential for animation deformity. On the other hand, subglandular placement is often better for patients with sufficient natural tissue who want a more augmented look with a faster recovery, though it may come with a slightly higher long-term risk of complications. Subfascial placement, while less common, offers a balanced solution for certain anatomies, giving a softer, more natural slope without full muscle involvement.

Dual plane techniques are frequently favored by modern surgeons because they combine the benefits of upper muscle coverage with lower tissue support—ideal for addressing both aesthetic preferences and mild sagging in one surgery. This versatility has made dual plane one of the most commonly performed techniques in breast augmentation today.

Additionally, implant placement plays a critical role in future breast aesthetics. As your body naturally changes with time, weight fluctuations, or pregnancy, how your implant was placed can affect how your breasts age. For instance, implants above the muscle may follow natural breast sagging more closely, while those under the muscle may hold their position longer but resist movement in ways that eventually feel less “natural.”

Understanding these distinctions can also help patients be better prepared for future revisions or enhancements. Whether your goal is minimal visibility, improved cleavage, athletic performance, or long-term stability, your choice in placement will play a major role in achieving those outcomes.

Ultimately, implant placement is one of the most critical decisions in your surgical journey—right alongside implant type and size. Choosing the correct plane of placement ensures that your results look balanced, feel comfortable, and hold up beautifully over time. That’s why this decision should always be made in close partnership with a plastic surgeon who understands how to customize your augmentation based on your unique anatomy, goals, and lifestyle