There are indications for placing implants both above or below the muscle. The majority of breast implants placed today are under the pectoral muscle. However, certain patients may choose to place the implant above the muscle.
Above the muscle placement is usually favored among bodybuilders. It may also provide a very small amount of lift to the breasts. Above the muscle placement does tend to have a higher capsular contracture rate. Additionally, saline implants are much more likely to show rippling or wrinkling in this position.
Under the muscle placement of breast implants does help reduce the risk of capsular contracture. With saline implants, it can help disguise rippling or wrinkling. Most surgeons and patients choose this placement because it offers a more natural breast contour and less risk in most cases.