Above or Below the Muscle: Where Do Korean Surgeons Place Breast Implants?
Korean clinics call dual plane, part under the muscle and part under the breast tissue, the most common choice, because many patients have thin upper-chest cover. When subfascial is offered instead, the 2cm pinch rule, and what each plane means for gym days.
Short answer: Korean clinics describe dual plane (이중평면) as the most common choice: under the chest muscle at the top, under the breast tissue at the bottom. Fully over the muscle is rarely used in Korea. Subfascial (근막하), just under the thin layer covering the muscle, gets offered when the upper chest pinches at 2cm or more. Thinner than that, and the muscle is there to hide the implant's edge.
The choice is about cover. A slim patient has very little between implant and skin on the upper chest, and that's where edges and rippling show.
What are the options?
| Plane | Where the implant sits | Main trade-off |
|---|---|---|
| Subglandular (유선하) | Under the breast tissue, over the muscle | Edges most likely to show; one Korean guide says it's barely used in Korea |
| Subfascial (근막하) | Under the muscle's fascia, muscle not cut | Little movement with exercise; needs thicker cover |
| Dual plane (이중평면) | Upper part under muscle, lower part under tissue | Hides the upper edge; more pain early, muscle can shift the implant |
| Fully submuscular (근육하) | Entirely under muscle | Least visible edge; firmer look, more distortion when flexing |
How do Korean surgeons decide which plane?
With a pinch and a caliper. Kim Eui-geon of UNE Plastic Surgery wrote in April 2026 that if the upper breast pinches at 2cm or more, subfascial becomes an option. Under 2cm, he recommends dual plane first. That cutoff comes from the US surgeon John Tebbetts' 2001 sizing system, which many Korean clinics cite.
He adds a second measurement beside the breastbone at the fourth rib: 20mm or more of soft tissue is comfortable for subfascial, 10 to 20mm is possible with a warning about rippling if you lose weight, and under 10mm rules it out.
Dual plane comes in Types I, II and III, depending on how far the breast tissue is freed from the muscle; the type is settled during surgery. The pinch also limits size, so plane and cc get decided together. See how Korean surgeons choose implant size.
Does going under the muscle hurt more?
Yes, for the first few weeks. Kim describes days 0 to 3 as the worst with either plane, with more muscle pain and chest tightness after dual plane. Over weeks 1 to 4, dual plane patients wait longer to lift their arms freely, while subfascial patients often go back to desk work after a few days. By six months to a year he sees almost no difference.
What happens when you work out?
With dual plane, contracting the chest muscle can squeeze the implant or push it up. Surgeons call this animation deformity. It shows most in push-ups and bench presses.
Subfascial leaves the muscle intact, so there's little movement, and some Korean surgeons steer heavy chest trainers toward it when tissue allows.
Park Young-ji of Uah Plastic Surgery made the opposite point in a 2024 column: thin patients and women with well-developed pecs from exercise are the ones she places under the muscle, with a modified dual plane meant to reduce that movement. Same patient type, different answer. Ask how your surgeon handles it.
Does placement affect mammograms or breastfeeding?
Park says her method avoids disturbing the milk ducts. Our posts on breastfeeding after augmentation and mammograms with implants go further.
Does the plane matter for a revision later?
It does. In a 10-year US study of Natrelle implants, capsular contracture was 15.7% under the muscle against 26.3% over it, and moving an implant under the muscle is a standard fix. See capsular contracture treatment in Korea.
How we help
- Free, itemized quotes from 2–3 specialist clinics, each stating the plane, implant and cc, so you can see whether two surgeons read your tissue the same way.
- An interpreter in the room when the surgeon does the pinch test and explains the plane.
- Consultations, surgery and follow-ups scheduled across hospitals, plus airport pickup. No charge to you.
Ask for free quotes from the form below.
Frequently asked questions
Do Korean surgeons put implants above or below the muscle?
Korean clinics describe dual plane, partly under the muscle, as the most common choice. Fully over the muscle is rarely used. Subfascial is offered when there's enough tissue cover.
What is the 2cm pinch test?
The surgeon pinches the upper breast. At 2cm or more, subfascial placement is an option. Under 2cm, Korean surgeons usually recommend dual plane to hide the implant edge.
Is dual plane more painful than subfascial?
Early on, yes. Korean surgeons describe more muscle pain and a longer wait to lift your arms freely after dual plane. By six months the difference is small.
Will implants under the muscle move when I work out?
They can. Chest exercises such as push-ups may squeeze or lift an implant placed partly under the muscle. Subfascial placement moves very little.
Get free, itemized quotes from 2–3 specialist clinics
Two taps and an email address. We ask clinics run by board-certified specialists for line-by-line quotes and the dates they can take you, and email them to you, usually within two business days. Free, and no obligation.
Keep reading
- Can You Get En Bloc Breast Implant Removal in Korea?
Yes. Korean clinics remove implants alone, with part of the capsule, or with the whole capsule, and en bloc is one form of the last. When a Seoul surgeon will say the capsule should come out, when they'll call it overtreatment, and what removal costs on Korean apps in 2026.
- Can You Do Breast Augmentation and a Health Checkup on the Same Trip?
Yes, if the checkup goes first. How the checkup's blood work, ECG and breast imaging overlap with pre-op tests, why the breast scans should come before surgery, and a 13-day sample schedule.
This guide is general information for people researching treatment abroad. It is not medical advice and does not establish a patient relationship. Only a licensed surgeon who has examined you can say whether a procedure is appropriate for you.