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What Surgery Type is Right for You: Subpectoral or Prepectoral?

What Surgery Type is Right for You: Subpectoral or Prepectoral?

One of the many aspects of breast augmentation surgery that will need to be determined is which type of surgery is right for the patient and this can include subpectoral (under the muscle) or prepectoral (over the muscle). Both surgery types are still commonly practiced by plastic surgeons, but the most common is subpectoral.

Subpectoral or Prepectoral

The decision to go subpectoral or prepectoral is usually based on the thickness of the natural tissue and the patient’s ability to hide the edges of the implant. There are three layers of soft tissue that surround the breasts and these include the outer layer of skin, the fat and connective tissue, and the breast gland itself.


When a patient’s breasts have ample fat and natural tissue it is usually not necessary to cover the implants by placing them under the pectoral muscle. However, in patients that do not have a lot of soft tissue to cover the implant, the pectoralis muscle can be used to cover the breast implants and provide more soft tissue padding. This is a long and triangular shaped muscle in the chest that can provides additional coverage for implants.

Benefits of Subpectoral Implants

  1. Studies have suggested that women with subpectoral breast implants are less likely to develop capsular contracture. This is a condition characterized by a firm and often painful condition that occurs when scar tissue forms around the implant.
  2. In patients that are flat chested with little soft tissue padding, a subpectoral placement offers the advantage of a more natural appearance when compared to the look of prepectoral implants.

Benefits of Prepectoral Implants

  1. In the first few days after surgery prepectoral implants are occasionally less painful. However, many surgeons will say that this should not be a deciding factor as patients that have subpectoral implants do very well by controlling the pain with the medication that is prescribed to them.
  2. In some cases prepectoral placement can help improve the shape and position of the breasts. This is particularly true with women that have mildly sagging breasts. Alternatively, there is also a technique called “dual plane” in which the implant is placed partially above and below the muscle. It too is often used for women that have a slight droopiness to their breasts and it can provide the benefit of both pre and subpectoral placement.


In many cases, the decision to place the breast implants over or under the pectoralis muscle will best be determined by your plastic surgeon. To learn more about breast implants contact Dr. Jonathan Lee, an experienced board certified plastic surgeon in Calgary who specializes in breast augmentation.