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Should Breast Implants be Placed Under or Over the Muscle?

My friend went under the breast muscle w/ her implants…but now it looks rippling on the bottom. During consultation with a respected plastic surgeon in LA he told me under the pectoral muscle is much better… less risk from capsular contracture, safer for breast cancer screening, more natural (less stripper looking…his words, not mine!). Thoughts?

Should Breast Implants be Placed Under or Over the Muscle?

Rippling is still possible going under the muscle.
‘Under the muscle’ placement of implants generally is not very accurate. The lower 1/4 to 1/3 of the implant, when going ‘under the muscle’, is, in fact, usually not ‘under the muscle’. It is covered by skin and breast tissue. The upper 2/3rd’s is usually covered by skin, breast tissue and muscle. I personally place all implants under the muscle except for a very specific situation called ‘tubular breasts’. The advantages that the LA surgeon laid out are exactly what I tell my patients.

Before and After Photos