Prior to the early 1990’s, almost all breast implants were placed on top of the muscle. Since then, the majority of plastic surgeons have changed to placing breast implants under the pectoralis major muscle because of the numerous advantages which include lower risk of capsular contracture, more natural appearance, less rippling, less interference with mammograms and lower risk of implant ‘fall-out.’

Implants on top of the muscle don’t get the support of the muscle, so, over time, there tends to be more sagging rather than less due to skin stretching. If implants provide a small lift initially when placed on top of the muscle, this is lost in a short period of time and you wind up with all of the other problems of subglandular implants.