Over-the-Muscle Breast Augmentation

What is Over-the-Muscle Breast Augmentation?

In an over-the-muscle breast augmentation procedure, medically known as a subglandular placement, a plastic surgeon places breast implants beneath the breast tissue but above the chest muscle. This option has advantages, like faster healing, but may not be right for everyone. If you're thin with very little of your own breast tissue, for example, over-the-muscle placement increases the risk of visible implant rippling. This guide will help you better understand how over-the-muscle implants work, when they’re appropriate, and when they’re not.

How Over-the-Muscle Breast Augmentation Is Performed

Performed under general anesthesia, over-the-muscle breast implant procedures typically take about an hour or two to complete. Here are the steps involved in completing one:

1. Your plastic surgeon will make an incision to access your breast. These incisions are most commonly placed around the areola, in the crease beneath the breast, or in the underarm.
2. A pocket is created for the implant to sit in. This pocket is placed under the breast tissue but above the muscles of the chest wall.
3. The implant is placed in the pocket and properly positioned within it.
4. All incisions are closed.
5. You wake up and go home. You’ll likely be wearing a surgical support bra when you do and will need to continue doing so for a time.

Benefits of Over-the-Muscle Breast Augmentation

Over-the-muscle breast implant placement is a good choice for many women. It offers several advantages over under-the-muscle placement. These include:

• Faster recovery time and a less painful recovery
• Initial healing is more comfortable, often described as mild pressure or tightness rather than muscle soreness
• Best for patients with sufficient natural breast tissue, ensuring a natural look without the need for muscle coverage
• Implants placed over the muscle are often easier to adjust or revise in future surgeries if necessary

What to Expect After Over-the-Muscle Breast Augmentation

You will notice some swelling, mild pressure, and tightness in your breasts and upper chest after an over-the-muscle breast augmentation. This is because your skin and breast tissue need time to stretch a bit and adjust to the larger breast size created by the implant. Because the chest muscles remain untouched, however, you won’t experience the muscle soreness and tenderness that you would if your implants were placed under your muscle.

Though you should expect mild pain and soreness for about a week after your surgery, this discomfort is typically mild and easily managed with pain medication. We can’t promise you that you won’t hurt at all after your surgery, but the pain experienced after an over-the-muscle augmentation is less intense than the pain reported after an under-the-muscle implant placement. This is true simply because over-the-muscle placement disturbs less tissue and doesn’t involve as deep of a disruption.

Recovery Timeline for Over-the-Muscle Breast Augmentation

When we say that recovering from an over-the-muscle breast augmentation occurs more quickly than an augmentation placed under the muscle, it doesn’t mean that you’ll see a big difference when comparing healing timelines overall. You’ll feel better more quickly, but the overall trajectory of the healing process doesn’t change much from one implant placement to the other. You can still expect your recovery journey to unfold in a similar manner to this:

• First Week: Initial Healing
  • Swelling and tightness peak within the first 48–72 hours
  • Discomfort will be managed using prescribed medication
  • Patients can often return to desk work within three to five days, depending on pain levels and tolerance
• Weeks 2–4: Gradual Improvement
  • Swelling begins to subside, and light activities can resume
  • Avoid heavy lifting or chest exercises
• Weeks 5–8: Returning to Normal Activities
  • Most patients can return to normal exercise routines, including upper body workouts, by week six
• Months 2–6: Final Results
  • Implants settle into a natural position
  • Any lingering tightness fades

How Painful Is Over-the-Muscle Breast Augmentation?

Recovering from surgery can be uncomfortable and even painful. Fortunately, over-the-muscle breast implants are more likely to be the former than the latter. Placing implants over the muscle creates a tight sensation but doesn’t cause the more painful muscle soreness that comes with placing them under the muscle. Although you may feel a bit uncomfortable for up to two weeks, most patients report that any actual pain is fully resolved within five to seven days.

When asking how painful a surgical procedure is, it's important to remember that everyone experiences and tolerates pain differently. Your pain level will be impacted by your personal tolerance for it as well as the specific conditions of your surgery. Inframammary (breast crease) incisions tend to be the least painful and heal the fastest due to a lack of tension and pressure on the area. Implant size is also a factor. The larger your implants, the more stretch and therefore discomfort they will cause.

Potential Risks and Considerations

All of life’s choices seem to come with both pros and cons, and selecting an over-the-muscle breast augmentation is no different. There are a handful of disadvantages to consider with over-the-muscle implants. These risks involve:

• The possibility of more noticeable implant edges in women with minimal natural breast tissue
• A slightly higher possibility of capsular contracture
• Potential for sagging in time since the implants won’t be supported by muscle

Recap & Next Steps

Over-the-muscle breast augmentation offers a quicker recovery, less pain, and ideal results for patients with enough natural tissue, but it does come with some potential downsides that you’ll need to weigh. The best way to ensure that you get the results you want from your surgery is to consult with a qualified plastic surgeon before your procedure and carefully consider their advice. At Mia Aesthetics, we happily offer free virtual consultations where you can get answers to your questions and personalized advice about whether or not an over-the-muscle breast augmentation might be right for you.