Once you’ve decided to get breast augmentation surgery, you’ll have several other decisions to make about the procedure. The most obvious is choosing the type and size of breast implants. One of the key decisions you’ll make with guidance from your plastic surgeon is whether the implants should be placed under or over the chest muscle.
Even though both options have merit, placing implants behind the chest muscle is the best approach for most breast augmentation patients. In this post, we’ll explain why a submuscular placement is typically preferable.
Subglandular vs Submuscular Breast Implant Placement
Placing breast implants over the muscle, also known as subglandular placement, involves positioning the implants directly behind the breast tissue but in front of the pectoralis major muscle. As its name implies, a submuscular placement involves inserting the implant under the chest muscle. The dual plane technique involves placing most of the implant behind the muscle.
Another option is called subfascial placement. This involves creating an implant pocket under the breast and over the muscle but under the fascia (the muscle’s surface). With this technique, the fascia covers the implant’s upper half more like the muscle would.
We can look at several factors when comparing the implant placement options:
Results
In most cases, a submuscular placement looks and feels more natural than placing the implant in front of the muscle. This is particularly true for women with minimal breast tissue because the implant edges may be more visible with an over-the-muscle placement, resulting in a less natural appearance. Placing implants behind the muscle creates a more natural breast contour.
WARNING:
This feature contains nudity. Please click OK to confirm you are at least 18 years of age and are not offended by such material.
Risk of Complications
The most common complication associated with breast augmentation is capsular contracture. Scar tissue forms around the implant as part of the healing process, creating a capsule that helps keep the implant in place. In some cases, however, the scar tissue hardens and squeezes the implant. This hardening can result in aesthetic problems and even painful breasts. Clinical studies show that the risk of capsular contracture is higher for patients with implants placed above the chest muscle.
Implants placed above the muscle also have an increased risk of visible rippling, especially if you get saline-filled implants.
Exercise
Subfascial placement may be a good option for active women who engage in upper-body workouts. Having the implant only under this fascia and breast, not under the muscle, can yield less animation change to the breast mound with vigorous exercise. Implant animation—when the breast implant noticeably shifts or distorts during muscle contraction—is a concern with submuscular placement.
However, I have many patients who work out regularly, who do body competitions, or who are fitness instructors who prefer and ask for under-the-muscle placements. As long as a patient understands the advantages or disadvantages of each placement, it is easy to arrive at a decision that best suits their needs.
Mammograms
Placing implants behind the muscle makes it easier for mammograms to detect potential breast abnormalities compared to placement above the muscle.
Recovery
Many plastic surgeons say recovery is shorter and more comfortable for patients with implants placed above the muscle. However, I use Rapid Recovery protocols for all breast augmentation procedures that minimize post-op discomfort and shorten recovery time. This includes using numbing medicine that can last 2 or 3 days after the surgery.
Long-Term Results
Over time, under-the-muscle placement tends to maintain a more natural feel and appearance. Implants placed over the muscle are more palpable, so the breasts feel less natural. There is also a little less of a natural transition in the upper part of the breast mound.
Creating Breast Harmony
Implant placement is one element of creating and maintaining breast harmony, producing breast augmentation results that look symmetrical, natural, and in proportion with your body.
As a breast augmentation specialist, I’ve performed thousands of breast enhancement procedures. If you’re considering getting breast implants and want to discuss your options with me, request a consultation using the online form or call my practice at (419) 534-6551 to schedule an appointment.
Leave a Reply