Breast implant placement is among the many decisions you’ll make before undergoing an augmentation procedure. Implants can be placed in three different ways in relation to the pectoralis major muscles in the chest. It’s important to conduct research and ask your plastic surgeon questions about the advantages and limitations of each placement option. Keep in mind that he or she will make certain suggestions based on your unique anatomy and body type, lifestyle, and desired outcome.

Above the Muscle – Subglandular

Subglandular placement situates the implants behind the breast glands, but on top of the chest muscle. This placement option typically gives the breasts a high, round shape. Since the pectoral muscles do not require dissection or detachment, most patients experience less post-operative pain and recover faster than they do following other placement methods.

Larger implants can be used with subglandular placement, as the musculature doesn’t have to surround them. However, it’s important to remember that only the skin and the existing breast tissue will support the implant. Additional disadvantages include a higher risk for the obstruction of a mammography and rippling, particularly in women with little existing breast tissue.

Below the Muscle – Submuscular

Submuscular placement situates the top two-thirds of an implant behind the chest muscles, while the lower one-third of the implant is behind fascia, or the connective tissue that binds the chest muscles. This placement option usually offers greater upper pole fullness because the breast tissue is pushed upward and the implant is supported from beneath by the fascia. Though submuscular placement may create a slightly less natural look than subglandular placement, the risk of implant visibility and rippling is reduced because implants are completely covered by soft tissues. Mammogram images may be clearer on women with implants behind the muscle versus over the muscle, and a surgeon may recommend submuscular placement if you are at a higher risk for breast diseases.

However, since the implant is beneath the chest muscles, there may be some implant distortion or movement when the chest muscle is flexed. Breasts may also appear higher on the chest wall after the surgery until muscles relax over time. Additional disadvantages include increased post-operative discomfort and a longer recovery period due to the invasive nature of the procedure.

Half Over, Half Under – Partial Submuscular

Partial submuscular, or dual plane placement, situates the top two-thirds of an implant beneath the chest muscle, while the bottom portion is supported only by breast tissue. This placement method can lift breast tissue and increase fullness, while allowing for a more natural contour to the upper portion of the breasts compared to subglandular placement. Similar to complete submuscular placement, mammogram images may be clearer than those with over-the-muscle implants.

The upper portion of a breast implant may be more susceptible to distortion during muscle flexion, while the lower portion may be more likely to ripple. The invasiveness of this placement option may also lead to an increased recovery period and prolonged post-operative discomfort.

Additional Risks

There are also slight risks for bottoming out and capsular contracture in breast augmentation procedures. The term “bottoming out” refers to when an implant shifts to a lower position in the breast pocket. This can make one breast appear lower on the chest wall than the other, and the nipple will be higher on the breast mound. While implant placement may be a factor in bottoming out, the occurrence is usually due to improper dissection of the breast pocket. A woman’s unique anatomy may also play a role in bottoming out, as some women have weaker ligamentous tissue supporting the base of the breast. The risk for implant shifting is highly surgeon- and patient-specific, but an experienced surgeon should be able to explain when bottoming out could be a problem for a particular patient.

Capsular contraction is an often painful condition in which collagen fibers form around, constrict, and squeeze an implant. The formation of these collagen fibers is triggered by the body’s immune response to a surgically placed foreign object. The condition is generally related to bacterial contamination, how the breast tissue is handled during surgery, and the inflammatory impetus.

Talk to Your Surgeon

While it’s important to perform your own research and have a general idea of what breast implant placement you would choose, you should consult your plastic surgeon before making any final decisions. Since there are many variables associated with breast augmentation, it is highly important that an individual surgical plan is crafted specifically to each patient. An experienced plastic surgeon can help you consider which breast implant placement option will best meet your goals while limiting the risk of complications.

Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including breast augmentation, breast implants, and more.

Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including breast augmentation, http://bayshoreplasticsurgery.com/ breast implants, and more.

Author Bio: Katie Perry is an online content editor in the Tampa Bay area. She posts articles about plastic surgery topics and procedures including breast augmentation, breast implants, and more.

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