Breast augmentation implants can be placed either on top of or below the muscle. There are different factors that determine which is the best placement for each patient. But in about 95% of our cases, Sub-Muscular placement is used at Cosmetic Surgery Associates, as we see this is the best option for most of our patients.
Sub-Muscular
This technique places the implant underneath the pectoralis muscle. This often gives a more natural contour of the breast since both the tissue and muscle will cover the implant. This option also aids in the visibility of mammograms. Until the muscle relaxes, the implant may sit high for several weeks. If patients have mild to moderate breast ptosis or droopiness, a Sub-Muscular dual plane technique is often used. This technique partially releases the lower portion of the muscle from the breast gland, allowing for a greater lift.
Our Philosophy
We consider Sub-Muscular positioning to be the ideal option when the supporting factors, such as implant size and type, complement this placement. If a thin or petite patient were to have implants inserted over the muscle, there would be apparent rippling. With this, most frames benefit more from Sub-Muscular placement.
We’ve developed a special technique at Cosmetic Surgery Associates that dramatically reduces pain after breast augmentation and shortens recovery. To learn more, please read our article published in the Aesthetic Surgery Journal.
Request your breast augmentation consultation today at our Maryland or Virginia location to find out your ideal breast implant placement.
Keshav Magge, MD, FACS
Board-Certified Plastic Surgeon
Honored as a Top Doctor by Bethesda Magazine and Washingtonian in both 2024 and 2025, Dr. Magge is recognized for his exceptional surgical skill, artistic precision, and patient-centered approach. A leading plastic surgeon in Bethesda, Maryland, he completed a fellowship in Craniofacial and Pediatric Plastic Surgery at Children’s National Medical Center in Washington, D.C., where he gained advanced expertise in facial rejuvenation and aesthetic surgery innovations.
Meet Dr. Magge
A. Dean Jabs, MD, PhD, FACS
Board-Certified Plastic Surgeon
Dr. Jabs is an award-winning, board-certified plastic surgeon recognized nationally for his expertise in creating natural-looking results and his warm, compassionate approach to patient care. Trained in NY at Columbia University, he served in the US Army and has special expertise in facial rejuvenation. He has over 35 years of experience and has consistently been voted a top plastic surgeon by Washingtonian and Bethesda magazine.
Meet Dr. Jabs
Franklin D. Richards, MD, FACS
Board-Certified Plastic Surgeon
Dr. Richards has been recognized as a Top Doctor by several prestigious organizations, including Castle Connolly, Consumers’ Research Council of America, and Washingtonian magazine. A leading plastic surgeon in Bethesda, Maryland, Dr. Richards is the past Chief of Plastic Surgery at Johns Hopkins Suburban Hospital. His expertise is in achieving natural results in facelift and eyelid surgery, with additional interests in cosmetic surgery of the breast and abdomen.
Meet Dr. RichardsPatient Photos
View our gallery to see photographs of real patient results at Cosmetic Surgery Associates.
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Patient education is one of our primary goals. Check out our educational video series to learn more about specific procedures and view real results.
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