Implant placement is one of the most consequential decisions in breast augmentation planning. It is often given less attention than implant size or type. Whether an implant is positioned over the chest muscle or beneath it affects how natural your results look, how implants behave over time, and what your day-to-day experience with your implants will be like.
At Steely Plastic Surgery in Houston, Dr. Steely evaluates each patient’s tissue thickness, breast dimensions, and aesthetic goals individually. He does not default to one placement technique for every patient. His approach is guided by a broader surgical philosophy: beautiful results come from balance and proportion, not a one-size-fits-all formula.
Subglandular vs. Submuscular Placement: A Quick Overview
Breast implants can be positioned in one of two general locations. Subglandular, or “over the muscle,” placement positions the implant directly behind the breast tissue and in front of the pectoral muscle. Submuscular, or “under the muscle,” placement positions the implant beneath the pectoral muscle. The muscle then covers a significant portion of the implant.
Each approach carries its own advantages depending on a patient’s anatomy. Neither is universally superior.
How Dr. Steely Determines the Right Placement for Your Breast Surgery
Choosing between subglandular and submuscular placement requires evaluating several anatomical factors together:
Tissue Thickness
Patients with thinner breast tissue generally benefit from submuscular placement. The additional muscle coverage reduces the visibility of implant edges and lowers the likelihood of palpable rippling. Patients with a moderate to large amount of existing breast volume often already have adequate natural coverage. These patients may be excellent candidates for subglandular placement instead.
Activity Level
Patients who are highly active, including those who participate in fitness competitions or rigorous strength training, sometimes prefer subglandular placement. This helps avoid interaction between implant position and pectoral muscle contraction during exercise.
Desired Aesthetic Outcome
Submuscular placement tends to produce a softer, more gradual upper pole slope. Subglandular placement can offer slightly more forward projection and a more defined implant shape in patients with sufficient tissue coverage.
Long-Term Considerations
Dr. Steely also weighs how each placement method tends to perform over time. This includes each method’s relationship to capsular contracture risk, since this can influence the durability of results.
The right placement supports the patient’s frame instead of working against it. In some cases, a dual-plane technique may offer the best balance of coverage and contour. This technique combines elements of both approaches. Dr. Steely will discuss whether this option fits your anatomy during your consultation.
Breast Surgery Recovery by Placement Type
Recovery experiences differ somewhat depending on which placement method is used. Submuscular placement involves the pectoral muscle directly. This can result in slightly more discomfort in the initial days after surgery as the muscle adjusts to the implant beneath it. Subglandular placement does not involve the chest muscle. Early recovery is typically more straightforward as a result.
Regardless of placement, Dr. Steely’s surgical technique is designed to minimize unnecessary trauma. His patients typically experience little to no bruising and do not require drainage tubes or bulky wrappings. Most patients return to non-strenuous activities within about a week. A gradual return to full exercise follows over the next several weeks, with submuscular patients sometimes needing slightly more time before resuming upper-body strength training.
View our Before & After Gallery to see real results from patients who chose Dr. Steely for their breast augmentation.
Physical Differences You May Notice Day to Day
Beyond the surgical and aesthetic considerations, placement also affects how implants feel and behave in daily life.
Submuscular implants are partially covered by the pectoral muscle. This can occasionally cause a phenomenon known as animation deformity. This refers to subtle shifting or distortion of the implant when the chest muscle flexes, such as during certain exercises or arm movements. It is generally more noticeable in patients with significant muscle mass. It tends to be a cosmetic consideration rather than a medical concern.
Subglandular implants are not affected by muscle flexion in this way, since they sit above the muscle. However, they have less natural coverage in thinner patients. The implant edge may be more easily felt by hand, particularly along the upper or lateral breast.
Dr. Steely discusses both of these practical considerations during consultations. They affect long-term comfort and satisfaction just as much as the initial aesthetic result.
Breast Implant Placement FAQs
Does implant placement affect mammogram accuracy?
Both placement types allow for accurate mammography. Submuscular placement can make it slightly easier to image breast tissue separately from the implant. Be sure to inform your imaging center about your implants and their placement ahead of any screening.
Does implant placement affect the risk of capsular contracture?
Some research suggests submuscular placement may be associated with a somewhat lower risk of capsular contracture compared to subglandular placement. Individual risk still depends on multiple factors. Dr. Steely will discuss this in more detail based on your specific anatomy.
Can implant placement be changed after the initial surgery?
In some cases, yes. Implant placement can sometimes be revised during a secondary procedure. This depends on the original surgical technique and the patient’s anatomy. This is a conversation to have directly with your surgeon if concerns arise after your initial augmentation.
Which placement is more commonly recommended?
There is no universal default. The right placement depends entirely on individual anatomy. Dr. Steely makes this determination based on a physical evaluation rather than a standard protocol applied to every patient.
Will animation deformity go away over time?
Animation deformity is related to muscle anatomy and implant position. It typically does not resolve on its own. Most patients find it to be a minor cosmetic consideration rather than something that affects daily comfort.
Dr. Steely’s Approach to Breast Implant Placement
Dr. Robert Lee Steely is dual board-certified by the American Board of Plastic Surgery and the American Board of Surgery. He has authored multiple published articles on the art and science of plastic surgery.
Every procedure at Steely Plastic Surgery is performed personally by Dr. Steely in his own AAAASF-accredited Class C operating suite. This surgical suite is located within his Houston office on Richmond Avenue in the Upper Kirby and Greenway Plaza area. The facility allows for a controlled, private environment that many patients find more comfortable than a hospital setting, while still meeting the same rigorous safety standards required of accredited outpatient surgical centers.
Dr. Steely has been recognized for his patient care and surgical outcomes through multiple Patients’ Choice Awards, Compassionate Doctor Recognition, and repeated Top Doctor honors from H Texas Magazine. Patients consistently note his attentiveness. This includes direct phone and email access for questions after surgery and personal follow-up during recovery.
When it comes to implant placement specifically, Dr. Steely’s planning process begins with a physical evaluation of tissue thickness, chest wall structure, and existing breast volume. From there, he builds a recommendation based on what will produce the most natural, proportionate, and comfortable long-term result for that individual patient.
Schedule a Breast Surgery Consultation at Steely Plastic Surgery
If you are exploring your breast implant placement options in Houston, contact Steely Plastic Surgery today to schedule a consultation with Dr. Steely. His Upper Kirby practice serves patients throughout the greater Houston area.