The Harley Medical Group

Medically reviewed by T K Sankar, Consultant Plastic and Reconstructive Surgeon

When it comes to considering breast augmentation (or breast enlargement), one of the most important questions that you should ask yourself is: “Should I have my breast implants placed under or over the muscle?”.

Unfortunately, there is not a one-size-fits-all approach when it comes to this decision, and the placement you decide depends on a range of factors, such as the results that you are looking for.

If you are considering breast augmentation surgery to help boost your self-esteem and confidence, here we explain the difference between under the muscle breast implants vs over, and examine the pros and cons of both to help you make an informed decision. 

Boob job types

Your first decision is to decide on the type of boob job you want to have. Your options for breast surgery include:

Breast implant types

Next, you need to decide on the type of breast implant that you want to have, there are two main types:

Think of a typical boob job and we’re sure these implants will come to mind! Round breast implants help to achieve more fullness in the top part of the breast, giving a curvaceous figure that is more in proportion as a result. 

These give a more natural, subtle shape as they slope gently from the nipple to the breastbone.

breast implant shapes

Learn more about the difference between teardrop vs round breast implants

The position of your breast implants

Once you have decided on the above, you need to choose your breast implant positioning option:

breast implant insertion

With breast implants under pectoral muscle, “the muscle” refers to the pectoralis major which is large and fan-shaped. When the breast implant is placed underneath it, the surgeon will detach the muscle from its lower origin along the ribs. As a result, the muscle will only cover about half of the implant, so the bigger your implant is, the less your muscle will cover. 

With breast implant over the muscle, “the muscle” refers to the pectoralis minor and serratus muscles, and the implant will also be placed below the pectoralis major muscle.

Breast implant under the muscle vs over

There are many differences, pros and cons between over the muscle and under the muscle breast implants. Our Consultant Aesthetic and Oncoplastic Breast Surgeon, Mr El-Gammal explains the difference. 

Over the Muscle (subglandular)

If you have a moderate amount of breast tissue (such as a B cup or larger), this type of breast implant placement can produce breasts that are very natural looking and will also age well. 

In addition, you will normally achieve your end results in a matter of weeks, and if your implant is placed completely on top of the muscle, you will not experience muscle tightness or breast deformity when the muscle contracts during exercise or day to day activities. 

If smooth implants are placed over the muscle, this may increase the risk of rippling. Around 70% of cases occur in the upper and inner aspects of the breasts, especially when the woman has smaller breasts to start with and has a more slender build.

Furthermore, it is also more likely that you will be able to see the upper edges of the implants too.

Under the Muscle (subpectoral)

When smooth implants are placed under the muscle, the risk of rippling is less than 10%. If you are of a thinner frame, by adding muscle bulk over the upper and inner aspects of the implants, it will be less likely that you will see the visible edges of the implant, and will have a more natural curve to your breast. 

Results may take longer to be achieved, and you may need to wait several months for your breasts to fully recover. It’s also important to be aware that when exercising or completing some normal daily movement, your pec muscle will contract and flatten the implant as it does, meaning they get pushed outward and your breast shape is caused to change. 

In some cases, you may see an indentation along the edge of the muscle, and if you have a moderate amount of breast tissue to start with, then in time, you may get a “waterfall deformity” from sagging, especially if it is lax or becomes lax in time.

 

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Recovery time

When the breast implant is placed above the muscle, the recovery is usually a lot easier and less painful. However, with under the muscle breast implants, you will normally have a longer recovery time, and for several days you may experience quite a bit of discomfort. Following this, it may take several months for any swelling to subside.

What else do I need to keep in mind? 

When considering the pros and cons of breast implants under the muscle vs over the muscle, it’s important to be aware that if placed completely under the muscle, you may have breasts that form a tight half-dome shape. This is not a result that most women want to achieve, so this is a key factor to keep in mind.  

Can breast implants come out from under the muscle?

If you have ever wondered this or whether breast implant under muscle movement will be an issue, then let us explain the risk in more detail. 

If you have under the muscle breast implants, it is possible that they can slip out or move as only the top half of the implant is covered by the muscle. If you are concerned about this, speak to your surgeon.

Key Learnings

When it comes to thinking about whether to have your breast implants placed over or under the muscle, there are a number of factors to keep in mind and speaking to your surgeon will help you to ensure that you get the best results for you and your body.

If you would like to improve your confidence, contact us to book your consultation with one of our expert professionals, where you’ll be able to discuss your enhancement expectations and requirements.

Our years of experience in the field of cosmetic surgery ensure that you can rely on The Harley Medical Group to assist you with a tailored treatment programme for breast surgery. We offer free non-obligation consultations with qualified Medical Professionals, as well as a thorough aftercare service to ensure that your experience is positive throughout your entire journey.

Medically reviewed by T K Sankar, Consultant Plastic and Reconstructive Surgeon

Following your breast augmentation surgery you will need to wear a particular kind of bra in order to support your breasts properly and aid your recovery, as well as fit your new breast size correctly. To help you prepare for this, we have put together some tips and advice to help you get the best results. 

What to wear to breast augmentation surgery?

If you have breasts that are uneven, have lost volume and fullness after weight loss or pregnancy, or you feel they are too small for your body shape, then having breast surgery may help to improve your self-esteem and confidence. 

Before your procedure, you will need to make sure that you are dressed appropriately when you arrive at the hospital. We recommend that you come wearing clothing that is loose-fitting before you change into a hospital gown. This includes a shirt that buttons or zips in the front, jogging bottoms or leggings – something that is comfortable is definitely best.

What type of bra should I wear after breast augmentation?

Most women wonder what to wear while recovering from breast augmentation or whether they can wear a wireless bra after breast augmentation. Below are more details on what type of bra you should wear post breast surgery.

Following your surgery, it’s important that you wear a suitable bra that aids your recovery and properly supports your new breasts. Most surgeons will recommend wearing a surgical bra after your surgery, which will allow your implants to remain supported while they settle into place, help to reduce swelling and aid the healing process. 

However, it’s important to be aware that although the pressure from the bra can increase your comfort, the final shape of the breast can be altered by certain bra types and your breasts may need some time to settle. As such, your surgeon may recommend that you wait before wearing a bra again. It’s therefore important to ask your surgeon for their advice.

When considering what post-surgery bra to buy, you should keep the following factors and questions in mind:

It’s important to ensure that your bra is wire-free to avoid it cutting into your skin due to numbness following the procedure. 

Softer fabrics that are high-cotton and stretchy will provide you with more comfort. 

Make sure the bra has adjustable straps and closures, ideally at the front so you don’t have to stretch or twist. 

You should ask your surgeon for their advice on how tight your bra should be following breast augmentation surgery and how much support you will need. 

When it comes to the size of bra to buy, this can be hard to predict – again, your surgeon should be able to give you advice in regards to your post-procedure size and any swelling you may experience. 

Following your surgery and once you have spoken to your surgeon to confirm your new bra size, it’s likely that you might want to go shopping. However, it’s important to properly look after your new bras so they last for as long as possible:

When can I stop wearing my surgical bra after breast augmentation?

We are proud to partner with Macom Medical, the UK’s leading distributor of medical-grade compression garments all designed in collaboration with doctors and surgeons with your optimised recovery in mind. @nadja_macom tells you everything you need to know about how best to help your recovery and why the @macom_medical compression bras are going to be the best form of support and care for you.

 

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No matter your breast procedure, it’s always important to ensure you wear your garment straight away to ensure you are supported as soon as possible after your procedure. Compression is extremely vital in allowing your breasts to recover effectively and safely after your cosmetic procedure, and to avoid any form of discomfort or infection as well.

When can I wear an underwire bra after breast augmentation? 

Your surgeon will be able to advise you on how long you need to wait, in order to ensure that your breasts have properly healed beforehand and will be able to be supported enough.

Key Learnings

Following breast augmentation surgery, a surgical or sports bra will help to provide the required levels of compression and support, ensuring that your breasts properly recover.

If you would like to improve your confidence, contact us to book your no-obligation consultation with one of our expert professionals, where you’ll be able to discuss your enhancement expectations and requirements.

Our years of experience in the field of cosmetic surgery ensure that you can rely on The Harley Medical Group to assist you with a tailored treatment programme for any breast surgery, whether that’s an enlargement, a breast uplift, or a combination of the two. 

We offer consultations with qualified Medical Professionals, as well as a thorough aftercare service to ensure that your experience is positive throughout your entire journey.

We caught up with Dr George Samouris, plastic surgeon at The Harley Medical Group who has been a well respected doctor for the past 18 years, and a plastic surgeon for the last 7 years.

Mr Samouris qualified as a doctor in 2004 following his studies at the University of Messina (Italy) and undertook his specialist training in some of the most prestigious hospitals in the UK and Greece. Serving as a Sergeant Physician at a Greek Air Force unit, he has also worked within the NHS and private hospitals across the UK for several years. He specialises in procedures such as breast enlargement, breast reduction, breast uplift, liposuction, abdominoplasty, rhinoplasty, ear reshaping, arm and thigh lift and upper eyelid blepharoplasty.

 

What would you advise a patient to do before booking their surgery at The Harley Medical Group?

My advice would be to get all of the information possible and do some research before meeting the actual surgeon.

What happens during the consultation process with the surgeon?

We see the patients in clinic and explain from our side what is best for them and if we can actually meet their expectations for surgery. We then go through the physical examination, explaining the risks and benefits of every procedure. I always advise my patients to look at all of the information available that’s easy to access online and look at some before and after images as well.

What’s the process of a Breast Augmentation procedure?

The Breast Augmentation is one of the most common procedures in cosmetic surgery. It is mostly done as a day case procedure, taking around an hour, with general anaesthetic most of the time. The access point would be just a small tiny incision under the crease of the breast and dissection of what we call a pocket or a space where the implant goes. This is always decided between the surgeon and the patient. Usually we offer a media of two cup sizes on every breast enlargement procedure.

What’s your favourite thing about being a surgeon at The Harley Medical Group?

There’s no better feeling than seeing a patient that is happy from their outcome.

Patient reviews

Janine's Story

Our lovely patient Janine, aged 39, recently visited us at our Harley Street Clinic for a Breast Augmentation. After breastfeeding all three of her children her breasts became saggy and disappeared taking her down to a AA cup. “I was really unhappy, I didn’t like looking at myself in the mirror, I didn’t want to go swimming or wear bikinis or anything like that. Everything I wanted to wear, I had to think how I could fit a padded bra underneath and if it would show.” After lots of research, Janine chose to go with Dr George Samouris at The Harley Medical Group for her procedure.

 

Sophie’s Story

Sophie came to see Dr George Samouris after her incredible weight loss journey left her feeling unhappy with her breasts.

“I lost 7 stone so my bra size went from an F to a nothing and there was a lot of excess skin. I knew someone that had come to The Harley Medical Group and I ended up having the same surgeon as them. I think when you know someone that’s had a really good experience you know what you’re going to get, so I came to The Harley Medical Group on her recommendation. I was really impressed and decided to go with them for my surgery.”

Click here to book your free virtual consultation and find out more about the procedures we offer.

Medically reviewed by T K Sankar, Consultant Plastic and Reconstructive Surgeon

Are you considering the possibility of having a breast lift or breast reduction? If you’re experiencing breast asymmetry, sagging or have very large breasts, you may be debating an uplift or a reduction. Here we discuss how these procedures work and consider some key questions to ask yourself in order to achieve your specific goals.

Do I need a breast lift or reduction? 

At The Harley Medical Group, we often get asked ‘should I get a breast lift or reduction?’ So, what’s the difference? 

Breast uplift surgery 

Known as a ‘ mastopexy ‘ in the medical world, this procedure aims to ‘lift’ the breast to create a perkier appearance. This is achieved through surgery under general anaesthetic. An incision is made so that skin can be tightened and any excess removed, which repositions the nipples to achieve your desired look. Unlike breast reduction, it doesn't involve the removal of any breast tissue (fat or glands). 

image of a breast uplift
A Breast Uplift carried out by Dr Pundrique Sharma

While the breasts may appear smaller as they are perkier, breast uplift surgery doesn’t actually reduce the size of the breast, meaning you shouldn’t require a smaller cup size. Depending on the look you want to achieve, a breast lift can be performed in conjunction with a reduction or breast augmentation

Learn more about breast uplift and augmentation. 

Breast reduction surgery 

One of the most highly-rated cosmetic surgeries in terms of patient satisfaction, breast reduction will quite literally lift a weight off your shoulders. 

Also known as ‘reduction mammoplasty’, it’s a procedure performed under a general anaesthetic where the plastic surgeon aims to create your desired look by removing excess skin, fat and glandular tissue (including lobules or milk glands). 

This will reduce both the weight and size of the breasts along with lifting them for aesthetic and health benefits. 

Things to consider:

Is your desire for surgery for cosmetic or health reasons? 

If your motivation is to improve the appearance of your breasts, then a mastopexy (breast uplift) could work wonders to rejuvenate your chest. 

But if back, chest, and neck pain—or skin irritation/infection in the breast crease—are affecting your health and wellbeing, then a breast reduction may be more appropriate. This is because it reduces the volume of large breasts and therefore the weight you have to bear. 

Find out more about common problems with larger breasts and how to know if a breast reduction is right for you. 

Could non-surgical options help? 

While cosmetic surgery has produced life-changing results for many women, it can be costly and carries potential health risks. You may therefore wish to consider some simple ways to improve the appearance of your chest and reduce any painful symptoms first. 

For example, a professionally fitted, supportive bra made from the right fabric can make all the difference to your body confidence and comfort. Once measured, the fitter will check that the bra straps and back are properly adjusted for your body.

Exercise and diet can go a long way in reducing the weight of the breasts and improving their appearance. There is also an increasing number of skin tightening cosmetic procedures that aim to lift the breasts without the need for surgery. 

Do you plan on getting pregnant or breastfeeding? 

If you are planning for a baby or to breastfeed, you may wish to postpone any breast reduction or lift surgeries until your family is complete. 

This is because pregnancy and breastfeeding cause fluctuations in hormones and weight that can counter the effects of plastic surgery in this area. Also, reduction surgery in particular may impact your ability to breastfeed your baby. 

Click here to read more about breast augmentations and pregnancy.

What are the risks of breast reduction and breast uplift?

Any surgical procedure carries an element of risk and should always be discussed with a doctor beforehand. Complications specific to breast reduction or lift surgery can include: 

However, the risk is dramatically reduced by following the aftercare advice provided by your surgeon. This includes maintaining good wound hygiene, wearing the correct supporting garments, and avoiding any physical activities that strain the area. 

How much will breast surgery cost? 

The Harley Medical Group offers a range of breast surgeries by our renowned surgeons, with varying costs

Book a no-obligation consultation with one of our experienced patient advisors to get all the information on breast reduction and breast uplift, as well as costs and financing options. 

Mother’s Day is a special occasion to treat all of the inspirational women in our lives.

To celebrate this year, we’re putting the spotlight on all of the amazing mum’s that have had surgery with us here at The Harley Medical Group. Carry on reading to see how we were able to change their lives and help them on their journeys to become happier, more confident mums.

Janine's story

Our lovely patient Janine, aged 39, recently visited us at our Harley Street Clinic for a Breast Augmentation. After breastfeeding all three of her children her breasts became saggy and disappeared taking her down to a AA cup. “I was really unhappy, I didn’t like looking at myself in the mirror, I didn’t want to go swimming or wear bikinis or anything like that. Everything I wanted to wear, I had to think how I could fit a padded bra underneath and if it would show.” After lots of research, Janine chose to go with Harley Medical Group for her procedure.

 
“I feel so much more comfortable in myself already and it’s only been 7 days post-op. I keep looking at clothes on the internet and what I can wear now, the children can go swimming again because I’ll feel comfortable. Some people may not understand but to me it has made a massive difference. I think the problem is now so many people do it because of social media to get DD’s and it’s all for the wrong reasons, when it’s for the right reasons, helping your confidence and self esteem, it is life changing.”

Hannah’s story

Hannah came to visit us in 2021 for the first of 3 surgeries after weight loss and pregnancy took a toll on her body.

“I absolutely could not fault The Harley Medical Group from start to finish! The service was second to none and I would not hesitate to recommend them to anyone looking for surgery.

I lost 6 stone over the past few years and had 2 children, both of which took its toll on my body, in particular my skin. I was left with a lot of excess skin to my breasts and stomach. This put my life on hold, I could not let anyone see my body and couldn’t look at it myself. I hadn’t worn a bikini for 21 years! I got in touch with The Harley Medical Group and underwent my first surgery in April 2021, which was breast uplift and implants. I went with Ms Helena Antoniadou as I knew I needed multiple surgeries, of which Ms Antoniadou could perform both. I wanted 1 surgeon to see me through my whole journey. I was so pleased with the outcome! I honestly cannot describe how thankful I am to Ms Antoniadou, she’s a phenomenal surgeon and has completely changed me and transformed my life! She has given me a future again, to which I will be forever grateful to her for. Looking at my before and after pictures I cannot describe the happiness and confidence this has given me again. I can only describe her as my angel. Thank you to her and all the amazing team at The Harley Medical Group! I look forward to being reunited with my bikini after 21 years!”
 
Considering life changing surgery? Click here to book your free, virtual consultation today with one of our trusted experts and see how we can help you on your journey towards greater confidence and self love.

Medically reviewed by T K Sankar, Consultant Plastic & Reconstructive surgeon

Whether you’ve already invested in a breast enhancement, or are considering it post-pregnancy, you will likely have a lot of questions. To help you on your journey, we’ve covered some of the most commonly asked queries below.

Please note this is just a general guide and you should always consult a medical professional about your personal circumstances.

Do breast implants affect pregnancy?

Understandably, women who are pregnant (or trying to conceive) worry about the potential effects of breast implants on their bodies and the health of their unborn child. 

According to T K Sankar, Consultant Plastic & Reconstructive surgeon, breast implants do not affect pregnancy. Those with implants can become pregnant and safely deliver babies. 

However, each body is unique and may go through distinct changes. During pregnancy, the breast tissue and skin may change, becoming looser or less firm. This can occur regardless of whether or not implants are present. To reduce this effect, women are advised to maintain a healthy lifestyle and avoid excessive weight gain. This can help minimise the amount of breast tissue stretching and potentially limit any post-pregnancy ptosis or breast sag.

It’s essential to keep up to date on this topic and speak with your doctor about any potential risks of breast implants during pregnancy.

Do I need to remove breast implants before pregnancy?

Women with breast implants understandably want to know if they will need to remove them before they become pregnant. At present, there is no medical advice that breast implants need to be removed before pregnancy. However, if you would feel more comfortable removing them, this will need to be done before you conceive. 

Find out more about breast implant removal here.

Please note that if you’re already pregnant, no type of plastic surgery is recommended. This is due to the dangers of anaesthetic and potential post-recovery complications (e.g. infection or blood clots). It’s safest to remove your breast implants post pregnancy or waiting at least six months after giving birth. 

Do breast implants sag after pregnancy?

Some other common questions from women who have had an augmentation procedure are ‘how do breast implants look after pregnancy?’ and ‘do breast implants sag after pregnancy?’ While implants do not alter during pregnancy—hormones, milk production (lactation) and weight gain cause stretching of the skin, which can then sag once breasts return to their pre-baby size. 

'Breast ptosis' (sagging) can be less noticeable for mothers with implants than those with natural breasts, but augmentation doesn't prevent the stretching effect that pregnancy has on the breast tissue. To reduce the appearance of breast implants sagging after pregnancy, some women may choose to have an uplift procedure, or larger implants fitted to fill out the loose breast tissue.

Breastfeeding after breast enhancement

Plastic surgeons often hear the question ‘can you breastfeed with breast implants?’. And while some women may experience difficulties, the vast majority will find that implants don’t affect their ability to breastfeed. This is because implants are placed under the breast gland, so they don’t disrupt the milk ducts. 

However, some implants are inserted through the nipple and areola, which can damage the ducts and possibly reduce milk supply. Other methods such as inserting implants underneath the breast or through the armpit shouldn’t have any effect on a woman’s ability to breastfeed. 

It’s therefore important to discuss the various approaches to inserting breast implants if you haven’t had children, or if you’re already a mother and are considering expanding your family.

Breast enhancement after breastfeeding

Pregnancy alters the body and a lot of women report an increased breast size during pregnancy that can ‘deflate’ when they finish breastfeeding. As a result, sagging can occur when breasts return to their pre-pregnancy size. An increasing number of mothers are therefore considering breast enhancement after breastfeeding. 

Breast rejuvenation after breastfeeding usually takes two different routes. Some women opt to reshape their natural breasts. This is called a ‘mastopexy' or breast uplift. This procedure involves the removal of any excess skin, as well as tightening the breast tissue. 

Other women may opt for breast implants after pregnancy and breastfeeding. This is usually to fill out the resulting saggy breast tissue. Those with existing implants may opt to have a breast lift surgery, or have completely new implants put in. While there is no evidence that breast implants change after breastfeeding, some women opt to invest in larger implants to improve the shape of the breasts due to the resulting changes in skin tissue. 

Women often approach us to ask how long to wait after breastfeeding to get implants. For natural-looking, long-lasting results, mothers are advised to wait between six and twelve months after they’ve finished breastfeeding before having a breast lift or augmentation procedure. It’s also advisable to complete your family before you undergo breast augmentation or rejuvenation.

This is because each pregnancy and subsequent time spent breastfeeding will probably stretch the skin, undoing the effects you have invested in. For the best results, the highest standard of aftercare is essential following any type of breast surgery.

Need help?

At The Harley Medical Group, our patients are our number one priority - we’ve developed our very own Breast Safety Charter that all of our teams and surgeons follow to ensure you receive nothing but the very best care.

If you are considering breast surgery, whether augmentation, implant removal or breast reduction, our expert plastic surgeons can advise which route is safest for you.

Book your free consultation today.

Breasts come in all shapes and sizes, but if you have one breast that is bigger than the other, then this may affect your confidence.

At The Harley Medical Group, we understand that uneven breasts can make you feel self-conscious, so we have put together a blog post to look into this condition in more detail.

Read on to find out your breast surgery options if you want to fix uneven breasts.

What are uneven breasts?

Uneven breasts (also known as breast asymmetry) affects more than half of all women, in fact some studies show that over 90% of women have a visible difference between the two breasts. So to a degree, it's actually normal. The problem occurs when that asymmetry is very obvious.

Image of woman with uneven breasts

Breast asymmetry occurs where a woman has one breast that is a different position, size, or volume to the other. There are three types of uneven breasts:

Although most women will experience a normal amount of breast asymmetry to a certain degree, if you notice a sudden change in the shape or size of one breast, then you should contact your doctor immediately so that they can investigate the cause.

What causes extremely uneven breasts?

There are several different factors that cause uneven breasts. From going through puberty, blood flow and water retention, breast asymmetry can also be caused by hormonal changes as a result of ovulation, breastfeeding (especially if one of your breasts receives more stimulation than the other or if you feed on the same breast most of the time) or even physical trauma to the breast.

In addition, juvenile hypertrophy (which results in the underdevelopment or overdevelopment of the breast) can also cause a noticeable difference in the appearance, size or shape of one breast compared to another.

Will uneven breasts even out?

As we have already learned, the size of your breasts may fluctuate due to factors such as hormonal changes and weight gain and a certain amount of breast unevenness is normal. However, it is highly unlikely that breast asymmetry will ever even out on its own.

How to fix uneven breasts

If the different sizes of your breasts are causing you concern, low confidence and are affecting your self esteem, there are a range of non-surgical and breast asymmetry surgery options that you might like to consider in order to correct the problem.

The majority of women manage asymmetry by non-surgical means - by picking the right clothes, bra and padding for them.

However, if you are wondering how to fix your uneven breasts surgically , here is some more information about the options that are available for you to think about:

If you have extremely uneven breasts due to volume differences, having a breast enlargement operation (where a breast implant is surgically inserted behind your breast tissue to make it bigger) can improve the appearance of your breast asymmetry.

Another option to consider is breast reduction surgery. This is where instead of having one breast enlarged in order to match the size and shape of the other, excess fat, skin and glandular tissue is removed from the larger breast to match the smaller one. As a result, this can help to reduce any discomfort that you may have such as back pain.

With a breast uplift and enhancement, you will have a combination of a breast enlargement to replace the lost volume and a breast uplift (where any loose skin is removed from the breasts and back and the breast reshaped and lifted).

Key Learnings

Although breast asymmetry is a very common condition, if it is affecting your confidence or self esteem, then having breast surgery can give you the appearance and confidence that you are looking for.

Contact us to book your no-obligation consultation with one of our expert professionals, where you’ll be able to discuss your expectations and requirements.

Our years of experience in the field of Cosmetic Surgery ensure that you can rely on The Harley Medical Group to assist you with a tailored treatment programme for breast asymmetry.

Book a free consultationRequest a callback

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