Symmetry implant - above or below chest muscle?

Hi Ladies

I wonder if anyone can help me. I’m about to have my expander implant replaced with a permanent implant (had LD recon). At the same time I am having another implant put in on the unaffected side for symmetry.

I seem to remember reading somewhere, although I can’t remember where, that it is advisable to have the implant placed under the chest muscle as it pushes the breast tissue forward and therefore makes any potential lumps (fingers crossed there won’t be any more!) easier to detect, whereas if the implant is placed on top of the muscle, it may hide lumps?

I spoke to my surgeon about this last week and he totally disagrees and wants to place it above the muscle as it is easier and less painful. Personally I don’t care about the pain or ease of surgery, I just want to be sure that if anything appears in the future, I will be able to feel it! He says that he wouldn’t do it if he thought it was a risk and says that it also won’t be a problem if I have a good sonographer for mammograms. But what if they’re not good?

My op is next Friday and I’m suddenly a bit panicked by it all. Has anyone else had advice re over/under muscle?

Many thanks ladies.

Ali x


I have an implant in my good side for symmetry. I never realised there was an option for where it would go, or that there were reasons for putting it under the pectoral muscle. All I can say is that mine is under the muscle, and it wasn’t painful.

Also, I it means that in future I am more likely to be evenly matched - as the LD implant is under the LD muscle, so it is well supported and unlikely to droop, so the other side is also well supported by the muscle so I won’t end up with one droopy one and one perky one. I think it also means that I will always have two perky ones which may be a bit odd when I am 85 (I am now 49), but I will worry about that then!

thanks for that. I’ve spoken to the Breast Care Nurse who relayed my question to my Surgeon. It’s a conversation I could have with him over the phone in a maximum of 5 minutes where he explains his reasons for doing it his way and then I go away and make a decision but he refuses to speak to patients over the phone or via email. He has now postponed my surgery next week, wants to see me for an appointment in a weeks time to discuss it. Grrrrrrrr. Think I’ve dented his ego by questioning him?!

Thanks for your reply. You’ve given me another couple of reasons to have it the way I want it. Whether he’ll agree or not is another matter!