Breast implants placement

Breast implants placement

Over the muscle or behind the muscle ? In order to understand implants placement, patients need to know a few things about breast anatomy. Breast are made of several layers : the rib cage, the pectoral muscles, the mammary gland, the subcutaneous tissue and the skin.

A few options are available to breast augmentation patients regarding implants placement :

  • The submuscular position (« under the muscle »).
  • The subglandular position (« over the muscle »).
  • A combination of these two positions : the dual plane technique (a portion of the implant is covered by the pectoral muscle while the other is not).

Breast implants positions : pros and cons

Subglandular placement pros

  • The implant stays still when the pectoral muscle contracts (the result is natural) with no deformation.
  • The procedure only causes low levels of pain or discomfort.

Subglandular placement cons

  • There is a risk of implant contours being visible in skinny patients (a pinch test can assess this risk in the cleavage area).
  • Implant rippling is also a risk with this position, which can be decreased by using silicone implants.

Submuscular placement pros

  • The upper edge of the breast implant is covered by the muscle for a more natural looking cleavage.
  • This position decreases the risk of capsular contracture.

Submuscular placement cons

  • Breast shape changes when the pectoral muscle contracts.
  • Postoperative pain is more significant than with subglandular placement but well tolerated by most patients.
  • When the breasts are slightly sagging, the implant does not follow this motion because it is held in place by the muscle cover.

What about the dual plane placement ?

  • The upper pole of the implant is well hidden behind the muscle, which offers a truly natural appearance of the cleavage.
  • The lower part of the implant fills up the skin envelope nicely, which lifts up the areola slightly.
  • This position offers a very natural evolution over time.
  • Breast shape is only slightly affected by muscle contractions.
  • The dual plane position causes less postoperative pain than the submuscular placement.