As a board-certified plastic surgeon at Oregon Cosmetic and Reconstructive Clinic, I spend time helping patients understand where a breast implant sits. Implant placement matters because it directly affects long-term support, movement, and how the breast ages over time.
While several implant planes can work well, my preferred approach in most cases is submuscular placement. I favor this option because it offers more durable implant support over time. That said, subglandular and subfascial placement can be very helpful in select situations, and I always tailor the plan to the individual patient.
Let’s walk through each option and how I think about them.
What Does “Implant Plane” Mean?
The implant plane describes the layer of tissue where the implant rests. Each plane changes how the implant is supported, how it moves, and how it looks years down the road.
The three main planes I discuss with patients are:
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Submuscular (under the muscle)
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Subglandular (over the muscle)
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Subfascial (under the fascia, above the muscle)
Submuscular Placement (My Preferred Approach)
With submuscular placement, I position the implant partially or fully beneath the pectoralis muscle.
Why I usually recommend submuscular placement
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Durable long-term support: The muscle helps support the implant as tissues naturally age
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Better coverage of the implant: This reduces visible edges and rippling
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More gradual upper-breast contour: Often creates a softer transition from chest to breast
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Reliable outcomes over time: This plane has the most long-term data behind it
Because of these benefits, this is my go-to option for many patients, especially those who want a result that holds up well as their body changes.
Considerations to keep in mind
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Animation deformity: The implant can move slightly when the chest muscle flexes
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More initial tightness: Muscle healing takes time
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Slightly longer recovery: Compared to over-the-muscle placement
Even with these trade-offs, I often feel the added durability and support outweigh the downsides for many patients.
Subglandular Placement (Helpful in Select Cases)
With subglandular placement, the implant sits above the muscle and beneath the breast tissue.
When subglandular placement can be beneficial
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No animation deformity: The implant does not move with muscle use
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Faster, less uncomfortable recovery
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More direct control of breast shape: Helpful in certain revisions or breast shapes
Limitations I discuss with patients
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Less long-term support: The implant relies more on skin and breast tissue alone
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Higher risk of visible rippling: Especially in thinner patients
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Potential for earlier tissue stretching over time
Because of this, I tend to reserve subglandular placement for patients who already have adequate natural breast tissueor specific anatomical or lifestyle needs.
Subfascial Placement: A Thoughtful Middle Option
Subfascial placement positions the implant beneath the fascia but above the muscle. I view this as a middle groundbetween submuscular and subglandular approaches.
Why subfascial placement can make sense
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More support than subglandular placement
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Less risk of animation deformity compared to submuscular placement
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May soften implant edges without disrupting the muscle
Important context
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Less long-term data: This is a newer plane
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Durability over decades is still being studied
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Not appropriate for all body types or implant sizes
For carefully selected patients, this can be a useful option, but I always explain that it does not yet have the same long-term track record as submuscular placement.
How I Personalize Implant Placement
Although submuscular placement is my preferred approach due to durability, I don’t apply it blindly. During consultation at Oregon Cosmetic and Reconstructive Clinic, I evaluate:
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Your existing breast tissue
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Chest wall anatomy and muscle activity
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Implant size and type
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Lifestyle, fitness, and work demands
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Long-term goals for breast shape and support
From there, we choose the plane that best balances support, movement, and longevity for you.
You can learn more about breast augmentation planning and recovery on theocrc.com, where I outline how these decisions fit into the bigger picture of surgical outcomes.
Final Thoughts from Dr. Jenq
When it comes to implant placement, support over time matters. That’s why I most often favor submuscular placement. However, subglandular and subfascial approaches absolutely have a role and can be excellent choices in the right setting.
The best plan is always the one that fits your anatomy, goals, and long-term expectations.
