When is it important to place the breast implants behind the muscle or subpectorally?
When the patient has small breasts, generally an A cup or smaller preoperatively, there is normally not enough breast tissue to cover the breast implants properly and the muscle tissue is needed to keep the breast implants from showing through the skin. When a patient wants to go to a large size, a full D cup or larger and does not have enough breast tissue and thin skin, then the muscle is needed to cover the breast implant and keep it from showing through the skin. A further problem of having too little breast tissue is rippling or contour irregularities. A submuscular placement can help prevent rippling over much of the breast implant, the part covered by the muscle.
