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In page Breast reconstruction:

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Although in the past, prosthetic implants were placed directly under the skin, this method has fallen out of favor because of the greater risk of complications, including visible rippling of the implant and capsular contracture.[1] The sub-pectoral technique described above is now preferred because it provides an additional muscular layer between the skin and the implant, decreasing the risk of visible deformity.[1] Oftentimes, however, the pectoralis major muscle is not sufficiently large enough to cover the inferior portion of the prosthetic implant. If this is the case, one option is to use an acellular dermal matrix to cover the exposed portion of the prosthetic implant, improving both functional and aesthetic outcomes.[5][6]