Breast Implant Placement Options

Decisions concerning breast implant placement is often left up to the plastic surgeon. But understanding the various placement options and how they may affect your results can be helpful when planning your breast augmentation and in choosing a plastic surgeon. The three basic breast implant placement options are subglandular, partial submuscular, and complete submuscular. All three place the implants behind the breast in various ways, and each has it's own advantages and disadvantages.

Subglandular (over the chest muscle): the least complicated placement option to perform, subglandular placement situates the implant between the breast tissue and the chest muscle, making finding a surgeon capable of performing the procedure quite easy. This method also offers less post-operative pain and a shorter recovery period than the other two options. Aesthetically, subglandular offers a rounder result, an effect some women seek and others find too "unnatural" for their taste. This method can also accommodate larger implants than other placement options, and can be used as a "quick fix" for mild drooping, postponing the need for more extensive breast lifting techniques. It should be noted, however, since there is no muscle or connective tissue support of the implants with this technique, this "quick fix" is only temporary, and drooping will most likely become more severe at some point after surgery.

Disadvantages of subglandular implant placement include more noticeable rippling and implant edges due to less tissue covering the implant. Capsular contracture (scaring around the implant causing hardening and implant distortion) is more common with subglandular placement, and "bottoming out", the downward migration of the implants, is somewhat common with this technique. Another important consideration is mammograms, which tend to be more difficult to perform when this method is used, with an estimated 40% increase in obstruction. Mammograms can be performed, however. But they require more images than traditional mammograms, an expense that may not be covered by insurance.

Partial submuscular (partially beneath the chest muscle): placing the top 2/3 of the implant under the chest muscle, this placement option offers what many consider a "more natural slope" than the over the muscle technique. It also hides rippling and implant edges better in the top portion of the implant than the subglandular placement option. Due to its partial placement beneath the muscle, it does involve more post-operative discomfort and a longer recovery period. Capsular contracture risk is decreased using this method, and mammograms are less hindered. But because the bottom portion of the implant is not supported by muscle fascia (connective tissue), "bottoming out" can still occur with partial submuscular placement.

Complete submuscular (completely beneath chest muscle and fascia): with this method, the top 2/3 of the implant is situated beneath the chest muscle while the lower 1/3 is supported by connective tissue, greatly reducing the risk of downward migration or "bottoming out". This technique offers a more natural, less round look then subglandular, as well as a reduced risk of capsular contracture and easier post-augmentation mammograms. Rippling and implant edges are much better concealed using this technique than the other two options. Complete submuscular placement does entail more post-operative discomfort than the other methods, and it is not performed by all plastic surgeons due to the skill it takes to master the technique. For women with widely spaced breasts, cleavage can be difficult to create using this placement option, and some women find their implants seem awkwardly high on their frame at first, until their chest muscle has had time to relax enough to properly accommodate the implants.

By evaluating your implant placement options and discussing them with your plastic surgeon, you can go into your surgery feeling better informed and create the breast enhancement results you seek. For more information about breast implant placement or breast augmentation, Tallahassee Plastic Surgery Clinic offers information and comprehensive consultations.