Submuscular vs Subglandular Breast Implant Placement (Dual Plane)

One of the most discussed topics when planning breast augmentation is the layer in which the implant will be placed. Subglandular (over the muscle), submuscular (under the muscle) and the combined dual plane approach are assessed according to the thickness of the breast tissue, skin quality, chest wall structure and the person’s daily life. This article outlines the general differences between these three approaches for informational purposes.

Subglandular placement

In subglandular placement the implant sits beneath the breast tissue and above the chest muscle (pectoralis major). Because the muscle is not divided, muscle-related tightness during the first days after surgery is usually felt less. On the other hand, only breast tissue and skin cover the implant, so in people with a thin tissue envelope the implant edges may become more noticeable. For this reason subglandular placement is generally considered when the breast tissue is of sufficient thickness.

Submuscular placement

In submuscular placement the upper part of the implant is positioned under the chest muscle. The muscle provides an additional layer of cover for the upper portion of the implant, which may help achieve a softer transition in the upper pole, particularly in people with thinner tissue. Because the muscle is elevated, tightness and tenderness are usually more pronounced in the first days, and the time needed to return to daily activity varies from person to person. How this placement affects the assessment of breast imaging is discussed by your radiologist and your doctor.

Dual plane placement

Dual plane is an approach in which submuscular and subglandular placement are combined in certain proportions. The upper part of the implant remains under the muscle while the lower part sits beneath the breast tissue. The aim is to benefit from the covering effect of the muscle in the upper pole while allowing the implant to settle in better harmony with the breast tissue in the lower pole. This approach may be considered in people with mild sagging or with a different tissue distribution in the lower breast. Within dual plane, different levels are defined according to how far the muscle is released, and the choice is entirely individual.

Factors that shape the placement decision

The decision is not made on a single criterion. Breast tissue thickness, skin elasticity, chest wall and rib structure, nipple position, the degree of sagging if present, the volume and profile of the selected implant, and the person’s occupational and sporting habits are all assessed together. Measurements and tissue thickness assessment carried out during the examination guide which plane may be more suitable. This is why two people with similar body measurements may be advised different placements.

Frequently Asked Questions

Does submuscular placement lengthen recovery?

Because the muscle is affected by the surgery, tightness and restricted movement are usually felt more during the first days. The pace of recovery varies from person to person; the timing of returning to daily life and to sport is determined together with your doctor.

Which placement is considered for people who exercise regularly?

In sports that heavily use the chest muscle, the effect of muscle movement on the implant is taken into account. Subglandular or limited dual plane approaches may then be considered; the decision is individual and depends on the type and frequency of the sport as well as the tissue structure.

Can the placement plane be changed later?

Where it is considered necessary, the plane can be changed with revision surgery. However this means a second surgical process, which is why detailed examination during the initial planning is important.

For detailed information about breast augmentation and implant selection you can review the breast augmentation page, and you can reach us through the contact page for an assessment.

This article is for informational purposes only; a medical examination is required for diagnosis and treatment.