It is currently the most common method of breast augmentation and is ideal for Asian women who often have relatively slim body types. This procedure places implants under the pectoralis major muscle and can be performed using transaxillary, periareolar, or inframammary incision or transumbilical breast augmentation (TUBA). Patients can freely choose between silicone gel or saline implants, both of which have smooth surfaces, or textured implants that require less massage. However, if one chooses TUBA, then only saline implants can be used. Dr. Chuang utilizes the latest high-definition endoscopy throughout the procedure to ensure the completeness and stability of tissue separation and to avoid possible complications such as nerve damage or bleeding that are associated with the traditional separation method.

This surgery places implants at the bottom-most layer of breast tissues, which are covered by thick soft tissues and the pectoralis major muscle. Therefore, it is ideal for patients who are thin or completely flat chested because implants are not felt by touch; edges or wrinkles are less obvious even with saline implants. However, this procedure requires the incision of some muscle tissues and results in more noticeable swelling and bruising. In addition, more pain could be observed after the procedure. Inappropriate breast massage could result in capsular contracture or breast deformation. In addition, for 3 months after surgery, patients should refrain from exercising, lifting weights using their arms, and wearing underwired bras to prevent implant suppression, which could cause the deformation or shrinkage of the internal space of the breasts. Patients in certain professions, such as athletes, dancers, or those involved in outdoor activities, should avoid submuscular implants because frequent arm activity can affect the shape and softness of the breasts.