Should implants be placed under or over the muscle?

There are several compelling reasons to place the implants under the pectoral muscle, which is behind the breast tissue: lower risk of capsular contracture, more thorough and easier mammograms, a more natural look for many patients, less visible rippling of the implants, and less sagging of the breast over time. The downside is a, high percentage of distortion of the breast with muscle flexion, called animation deformity. Using the traditional technique for submuscular placement of (dual plane), this occurs to some degree on more than 3 out of 4 cases. In order to achieve the benefits of going under the muscle without the common problems, I developed the split muscle technique: