Blogs » OVERS or UNDERS?



Every woman who had thought about having or who had breast augmentation using an implant may have encountered the “over or under” dilemma. It’s also one of the most debatable part of the breast augmentation procedure with surgeons having different opinions about which approach is better than the other.

In general, since the best result that we can get from cosmetic surgery is by tailoring the procedure for each individual patient, no approach should be considered far more superior than the other.

To give you a picture of what your surgeons consider for their recommendation however, the following are the different implant placement techniques and their benefits and indications:

1.      Subglandular: This implant placement is also what is popularly known as the “overs”. Though all breast implant placement can be considered sub glandular, this placement is termed “overs” because the implant will be placed just under the mammary gland, over the muscle.  According to cosmetic surgeons who specialize in breast surgeries, this approach gives the breast some sort of roundness that may seem unnatural for some. This approach is however the easiest for any surgeon as muscle dissection will not be involved. With this, recovery will be faster since there will be lesser tissue damage. With lesser complexity, this approach is often used for those wanting to have very big implants. On the down side, “overs” is also the most prone to rippling and palpability since only the breast tissue is covering the implant. Capsular contracture is also more common for patients who elected sub glandular placement. This technique is also not advisable for patients who have minimal breast tissues to begin with.

2.      Subpectoral: This is the implant placement that is now popularly known as the “dual plane technique”.  With this approach, the upper half of the implant is placed under the muscle while the lower half is just beneath the mammary gland, placing it still under the support of breast and skin tissue alone. The main advantage of this approach is that it allows clearer viewing for mammogram. Since the upper part of the implant will be covered by muscle, the result for this procedure may also look and feel more natural. On the down side however, since muscle dissection will already be involved, recovery may take longer and since no muscle is supporting the lower part of the implant, downward bottoming-out is often experienced in the long run.

3.      Submuscular: From the term itself, submuscular is what is also known as the “unders”. Submuscular placement of the implant means that the whole implant will be placed under the muscle. Since the implant will be completely covered by the muscle, rippling is highly unlikely along with visibility and palpability. The risk of capsular contracture is also lower with this approach. On the other end, post-op pain and discomfort may be more than other technique especially with bigger implants. During the first few days after surgery, the breast may also look a bit higher in position and it may take a few months before the result settles.


Remember that though it is good to know other people’s experiences with breast augmentation, keep in mind that no two breasts are exactly the same, your left and right aren’t, and your breast will never be the same with that of your friend even if you are of the same age, height, and weight so what worked for her may not work for you.

Since all approaches have their own advantages and disadvantages, and each breast is different from one another, the best way to assure that you can get the result that you want is by finding a surgeon who has enough experience with breast surgeries and breast augmentations. Find a surgeon who will explain each of the approach to you and not one who will tell you that one technique will universally work for everyone. Find a surgeon who you can trust and a surgeon who is well versed in performing all these techniques so you can be assured that you will be well advised not because it is within your surgeon’s comfort zone, but because it is the best approach for your unique anatomical contour.

The decision of where to put the implant will still be on you, but before you make that final call, consider only what your surgeon objectively gave you as professional advice, think not of your friend’s breast looking fantastic on this or that approach because with breast, and with all other cosmetic surgeries, every approach is unique for everyone.

For more information on breast augmentation, contact Yoskarn Clinic today!



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