# Submuscular Breast Augmentation > Citation bundle for Submuscular Breast Augmentation on The Treatment Registry. > URL: https://thetreatmentregistry.com/procedures/breast-augmentation-submuscular > Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/breast-augmentation-submuscular - Category: cosmetic-surgery - Average recovery: 21 days - Typical sessions: 1 - Price range (USD international): $4,500–$9,500 ## Description Submuscular breast augmentation places the implant beneath the pectoralis major muscle, in contrast to subglandular placement under the breast tissue alone. The submuscular approach (which is most commonly the 'dual-plane' variant, where the upper pole of the implant is fully submuscular and the lower pole is in the subglandular plane) is preferred for patients with thin breast tissue, thin overlying skin, or a preference for a more natural-looking upper-pole transition. Compared to subglandular placement, submuscular implants have lower capsular contracture rates, better mammographic visibility, and a smoother appearance under thin tissue — at the cost of a longer recovery, more initial post-operative pain, and visible 'animation deformity' on chest contraction in some patients. ## Overview Submuscular and dual-plane breast augmentation has become the predominant approach for breast augmentation in most contemporary practice, particularly for patients with limited soft-tissue cover or after substantial weight loss. The classical submuscular plane offers superior implant coverage in the upper pole; the dual-plane technique addresses the well-known animation deformity by partially releasing the muscle origin so the lower pole sits in the natural subglandular plane. ## Peer-reviewed outcome rates - **Complication rate:** 8.00% (range 5.00–12.00%) — from 1 cited source - **Revision rate:** 12.00% (range 8.00–18.00%) — from 2 cited sources ## Common risks - Capsular contracture (lower rate than subglandular) - Animation deformity - Implant displacement - Bottoming out - Asymmetry - Sensory changes ## FAQs ### What is animation deformity? When the pectoralis major contracts (during exercise or arm movement), submuscular implants can visibly move or distort. This is most pronounced in fully submuscular placement and is minimised by dual-plane technique with partial muscle release. Animation deformity is largely cosmetic and rarely requires revision unless severe. ### Why submuscular rather than subglandular? Submuscular placement has lower capsular contracture rates, better mammographic visibility for cancer screening, and a more natural upper-pole transition in patients with thin tissue. For patients with substantial natural breast tissue, subglandular placement may produce a softer, more 'natural-moving' result without animation concerns. ### Will I lose strength in my chest after submuscular augmentation? Most patients do not experience meaningful long-term loss of chest strength after fully submuscular or dual-plane placement. Some athletes (powerlifters, bodybuilders) may notice changes; these patients sometimes prefer subglandular placement for that reason. ### How long until I can exercise? Light walking from day 1. Lower-body exercise from week 2-3. Full upper-body exercise (chest, shoulders, back) from week 6-8. Specific guidance from the surgeon should be followed; over-eager return to upper-body work is one of the more common precipitants of implant displacement. ### Is the capsular contracture rate really lower? Multiple studies (and ASPS data) support a lower capsular contracture rate with submuscular placement, particularly with smooth implants. The absolute rates vary by study but typical 10-year rates are 5-10% submuscular vs 15-25% subglandular. ### How much does it cost compared to subglandular? Identical pricing at most clinics — the implant and operative time are the same. The cost driver is the implant itself, not the pocket location. ### Will submuscular implants affect my ability to breastfeed in future? Submuscular placement does not affect milk-producing glandular tissue and most studies show no impact on breastfeeding success rates. The incision approach (peri-areolar, infra-mammary, trans-axillary) has a larger effect on nipple sensation than pocket location does, and peri-areolar incisions carry the highest reported nipple-sensation-disturbance rate. ### Can I switch from subglandular to submuscular at a revision? Yes — pocket-conversion from subglandular to submuscular (or to dual-plane) is a common revision procedure, often performed for capsular contracture or for thin tissue cover. The capsule from the original pocket is typically excised; the implant is exchanged at the same operation in most cases. ## Sources - [ASPS — Quality and Health Policy practice parameters](https://www.plasticsurgery.org/for-medical-professionals/quality-and-health-policy) — American Society of Plastic Surgeons (accessed 2026-05-09) - [ISAPS — International Survey on Aesthetic/Cosmetic Procedures](https://www.isaps.org/discover/about-isaps/global-statistics/) — International Society of Aesthetic Plastic Surgery (accessed 2026-05-09) - [RCoA — Guidelines for the Provision of Anaesthetic Services (GPAS)](https://www.rcoa.ac.uk/standards-of-clinical-practice) — Royal College of Anaesthetists (accessed 2026-05-09) - [WHO Surgical Safety Checklist](https://www.who.int/teams/integrated-health-services/patient-safety/research/safe-surgery) — World Health Organization (accessed 2026-05-09)