Breast Implant Placement Techniques: Advantages and Disadvantages
This section provides an overview of some of the primary advantages and disadvantages of the various breast implant placement techniques. This information evolves over time, albeit at a slow pace. We do update this section as new information becomes available, so please refer back to it as time passes!
Appearance
Nothing written here is a substitute for talking about these issues in detail with your plastic surgeon, but here are some guidelines so you'll be prepared when you do!
- If you have adequate breast tissue to cover the size breast implant you want, above the muscle placement can give you a very natural look. (See our section on choosing breast implant size!)
- If you have little natural breast tissue or desire an implant larger than your natural breast tissue can cover, you may achieve a more natural looking result with either a complete submuscular or partial submuscular placement.
- Women who lift a lot of weight (think female body builders) may see distortion with any placement below the muscle because of the strength and flexion of the muscle.
- In most women with average to little breast tissue, under the muscle placement (either partial or complete) can help to avoid the “fake” look of implants.
- If you have a lot of sag or droop, you may require a breast lift (mastopexy) if you elect for either partial submuscular or fully submuscular placement. If you do not get a breast lift at the time of your breast augmentation, the breast implant will align with your chest wall instead of your breast tissue.
- If you have sag and you do not want a lift, you may be better off having your implants placed over the muscle.
Capsular Contracture of Breast Implants
Many surgeons believe, based upon clinical studies regarding placement of breast implants and contracture rates, that placing the implant either partially submuscular or completely submuscular reduces the rate of capsular contracture when compared to over the muscle placement (also known as subglandular placement). Keep in mind that there is not total agreement as to whether this is truly the case. One alternative that has been suggested to prevent capsular contracture is the textured breast implant. Whether this is true is also the subject of some debate. Furthermore, many believe that textured implants are more likely to create visible rippling. Surgeons who disagree with this view of textured implants claim that rippling is a result of improper filling of saline breast implants and not at all with the surface of the breast implants.
Rippling of Breast Implants
If you have little breast tissue, partial submuscular breast implant placement or fully submuscular breast implant placement is likely to reduce the chances of visible rippling of the breast implant. This is because the implant is partially or fully covered by muscle, in addition to breast tissue. The extra padding created by using the muscle to partially or completely cover the implant hides potential rippling beneath a thicker layer of tissue.
Mammography & Breast Implants
Mammography technology and doctors' ability to interpret the images has been and continues to continuously improve. Even so, most plastic surgeons believe that partial submuscular or fully submuscular placement makes mammography images clearer and therefore easier to read and interpret.
Sagging
Many plastic surgeons contend that over the muscle breast implant placement is more likely to lead to sagging as you age. In a complete submuscular placement or a partial submuscular placement, the breast implant may be better supported resulting in less sagging of the augmented breast over the long term.