Choosing Your Implant Placement

May 17, 2016 Norman H. Rappaport M.D.

Breast augmentation comes with many choices today, including the location of the implant placement. There are two basic places where your plastic surgeon can place your implant. The first is on top of the pectoral (chest) muscle but behind the glands of the breast, known as subglandular placement. The second is underneath the pectoral muscle, known as submuscular placement. Which implant placement will give you the best results?

Subglandular Placement

In the past, subglandular placement was typically the technique used for all breast augmentation procedures. However, some of the drawbacks of this technique, including the ability to see the edges of the implants in some patients, led surgeons to begin using submuscular placement with greater frequency. Despite the change, there are still times when subglandular placement is still the optimal choice, particularly when softer silicone implants are used for the augmentation procedure. Some of the benefits of subglandular placement include:

Less discomfort and a shorter recovery period
Closer placement of implants can result in better cleavage
May allow for larger implants, depending on the amount a breast tissue
Silicone implants allow for natural look and feel to the breast
No distortion of the pectoral muscle when contracted

Despite the benefits of subglandular placement, there are some drawbacks as well:

May create a more rounded, less natural look to the breasts
May be more susceptible to visible rippling
Could interfere with some mammogram images
Might lead to a higher risk of capsular contracture
Could result in more wear and tear to the breast skin

Submuscular Placement

Submuscular placement involves placing the implant behind the major chest muscle known as the pectoralis. The muscle may cover the implant completely or just the upper half of the implant may be covered. Submuscular placement offers the following benefits:

A more natural look, particularly for patients with very little breast tissue
Reduced chance for visible rippling
Lower risk that the bottom portion of the implant will be seen
May lower the risk for capsular contracture
Less distortion on mammogram imaging

At the same time, submuscular placement may lead to the following disadvantages:

Could cause more post-operative discomfort and a longer recovery period
May limit the size of the implants used
Could lead to distortion of the chest muscle when it is flexed

Making the Choice

Like your choice of which implants to use, the decision of where to place your implants is a highly personal one that needs to be made between you and your plastic surgeon. There are many factors that will go into determining the best placement for you, including the type of implant used, the size of the implant and the amount of natural breast tissue available. The ultimate goal is to choose the implant and placement that will give you the most natural, aesthetic pleasing results possible.

Dr. Rappaport has helped hundreds of women achieve their aesthetic goals through breast augmentation. He will work with you individually to understand your concerns and the results you are hoping to achieve. By partnering together to make all the decisions leading up to your surgery, you are more likely to have the safest and most successful results possible. To learn more about implant placement in breast augmentation, contact Houston Center for Plastic Surgery at (713) 790-4500.