There are two placement options for breast implants. During your breast augmentation surgery, you can have your breast implants placed either over the muscle (called subglandular placement) or under the muscle (submuscular). Submuscular placement is recommended for a number of reasons: it can reduce your risk of capsular contracture, and reduce the chance that the implant will be able to be seen or felt after your surgery. From a cosmetic standpoint, it is especially recommended if you don’t have a lot of natural breast tissue, but want to get saline breast implants. One concern some women have about submuscular implant placement is whether they will look or feel unnatural when you perform arm exercises or flex. When breast implants are placed under the pectoral muscle, they do interact with the chest muscles, but significant distortion is uncommon. One study looked at photographs of submuscular breast augmentation patients who were flexing. About 85% had minimal or no distortion when evaluated by a trained plastic surgeon. About 10% had moderate distortion, and only 5% had severe distortion. When patients were asked about their level of distortion, the figures were about the same. Of patients responding to a questionnaire, 82% said they had mild to no distortion, 10% said they had moderate distortion and 7% said they had severe distortion. Most commonly, patients reported distortion being visible when weight lifting (24% of respondents) or exercising (19%). However, only 1% of respondents said they would not recommend submuscular placement of breast implants. Breast distortion as a result of muscle action is another thing you have to keep in mind when considering breast implant placement. It is important to balance this and other drawbacks against the many benefits of submuscular placement in order to make the decision about which breast implant placement is right for you. Dr. David A. Bottger will discuss this decision during your personal breast augmentation consultation. To schedule your consultation, please call or email us today.