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Corpus Christi, TX  (361) 993-2222
Max Gouverne Cosmetic Surgery

Best Breast Implant Placement: Above or Below the Muscle?


The above the muscle vs. below the muscle controversy in breast implant placement continues to exist.

Q: I’ve looked at a website and it says “under the muscle is better”. Which do you recommend?

A: This is one of the most frequently asked questions at a breast augmentation consultation in my Corpus Christi practice. The short answer is that there is no simple answer that is the same for everyone. Beware of blanket recommendations that one surgeon only does it one way and that is the BEST way.

Our Approach to Breast Implant Placement

Three different breast implant placement methods are used today with a number of variants.

Sub-glandular is the oldest and most frequent approach. Sub-muscular was popular about 20 years ago. Dual-plane was added 10 years ago and finally sub-fascial is now available.

There is tremendous variation in natural breast shapes, degree of droopiness, skin turgor, implant size desired, body fat, amount of breast tissue present, degree of separation between the breasts, degree of enhancement, among others.

Our approach is to match the best technique, to the patient’s wants and needs. Only then can we deliver the best result for that patient.

The nulliparous (thin) athletic 20-year old deserves a different approach than the patient with postpartum involution. Each method has their own set of distinct advantages and disadvantages.

We bring over 20 years of cosmetic surgery experience and thousands of breast augmentation procedures to every patient we work with. We are here to provide our advice to help select the best method for you.

We use all kinds of different types of implants, each with specific advantages and disadvantages and each kind requiring a unique plan as to size, placement site, and desired outcome.

In conclusion, the sub-muscular, sub-glandular, dual plane or sub-fascial choice depends on your anatomy, your type of implant, your wants and desired outcome. Ultimately it is a balance between each position’s advantages and disadvantages.

My approach is — customization!

Each of my patients is unique and picking the best method for her breast augmentation (sometimes breast lift) is achieved by a carefully balancing pro’s and con’s.

You deserve to be part of that decision and ultimately you and your plastic surgeon decide on the best surgical plan for you.

Please email our office or call (361) 993-2222 to schedule your consultation and we would be happy to help you with this most-important decision.


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Dr. Max Gouverne

Dr. Max Gouverne is a board-certified plastic surgeon in Corpus Christi with more than 20 years of practical experience. Paired with his approachable personality, his advanced knowledge and employment of leading-edge techniques ensure your utmost safety, comfort, and satisfaction.

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Dr. Max Gouverne, MD
Cosmetic Surgery

5642 Esplanade Drive
Corpus Christi, TX 78414

Phone (361) 993-2222 Monday–Thursday:
8 a.m.–5 p.m.
Friday: 8 a.m.–12 p.m.