There are two anatomical locations for implant placement in the breast. The implant can be placed below the muscle or placed above the muscle of the chest.
Studies have shown that if you place an implant under the muscle, it decreases the incidence of capsular contracture. When an implant is placed under the muscle, the muscle of the breast, which is the pectoralis major muscle, is dissected from the lower part of its attachment and then a pocket is created under the muscle and the implant is placed. The implant is then inserted. It is believed that as the pectoralis major muscle essentially squeezes the implant during daily activities and movement, the implant is compressed and released, breaking any scar that is forming and making capsular contracture less likely. In other words, the muscle massages the implant. Another theory is that the space created under the muscle is less likely to create a contracture than the pocket above the muscle because of the vascularity of the muscle. In addition, some believe that because the muscle is more vascular, it is less prone to infection.
When you talk to your surgeon, discuss your concerns about capsular contraction, where your implant will be located, and how to decrease the likelihood of having a capsular contracture. In my practice, most implants are placed under the muscle, since this decreases the risk of not only capsular contracture, but also other complications like implant rippling and implant palpability.