Among a host of other important questions that you should ask during your breast augmentation consultation is “where the breast implants will be placed?”
Many patients are not aware that there is an option when it comes to the placement of breast implants. Implants may be placed either over the muscle or under the muscle, and there are several factors that help determine the best implant placement for each of our patients, including:
- Your body type
- Your current health
- The actual size (cc’s) of the implants
- Saline vs silicone implants
- Your individual goals and desires
Board-certified and experienced cosmetic breast surgeon, Dr. Laliberte, has performed a high volume of breast augmentation surgeries and will be able to direct the best position to determine ideal implant placement, and it is extremely important for breast augmentation patients to understand the pros and cons for the two different placement options.
Dual Plane Breast Implant Placement
Dual-plane breast augmentation refers to the placement of a breast implant in a specific anatomic position — partly behind the pectoralis muscle, and partly behind the breast tissue. The layers of the breast, from external to internal, are skin, breast tissue, pectoralis muscle and ribs. Plastic surgeons have debated the best plane for implant placement over many decades — some preferring placement between the breast tissue and the muscle (the “subglandular plane”), and others preferring placement between the muscle and the chest wall (the “submuscular plane”).
PROS: The dual plane technique comes in very handy in cases of breast deflation with ptosis (sagging), which occurs after having children, breastfeeding, losing weight, or naturally with time. In these cases, a dual plane allows the implant to be placed slightly lower to fill the lower pole of the breast and give a lifted appearance during breast augmentation.
Subglandular Breast Implant Placement
Also known or referred to as “over-the-muscle” placement, the subglandular placement technique is where the implant is positioned between the chest muscle and the existing breast tissue areas. The over the muscle positioning is done so the implant lies below the glands of the breast, thus providing the ability for the patient to breastfeed in the future.
PROS: Patients tend to have less movement of the implants during physical activity, as well as less discomfort immediately following the surgery.
CONS: The appearance can be more artificial. In addition, during mammograms, the readings may be less accurate. Also, patients may experience a higher rate of capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant.
Submuscular Breast Implant Placement
The other option is known as submuscular, or under-the-muscle placement of the breast implant. This technique includes placement of the implant partially under the pectoralis major chest muscle.
PROS: Patients experience more accurate mammograms. In addition, the submuscular placement tends to produce a more natural appearance and a reduced rate of capsular contracture.
CONS: Some patients experience slightly more discomfort after surgery, with a longer postsurgical recovery.
The role of the chest muscle
The muscles in the chest play an important role in breast augmentation procedures with regard to the ideal placement of the implants. Each individual patient will vary in the amount of muscle they have and this could be a factor in determining whether subglandular or submuscular placement is best.
The anatomy of each patient must be factored in. For example, women who have very large or strong chest muscles will be best suited for over-the-muscle positioning of the implants. One reason for this is with larger chest muscles there will be a tendency for distortion of the breasts as the chest muscles move and are flexed. In these cases, subglandular placement is advised.
How much breast tissue is present
In addition to the muscle density and mass, the amount of tissue in the breast area before surgery will also have an impact on where the placement should be for optimal postsurgical results. When there is a significant amount of breast tissue, there will be adequate soft tissue coverage making the pectoralis muscle superfluous in this regard.
As you move through the process of selecting your breast surgeon, and during your consultation about the procedure, you will want to discuss the placement of the breast implants, going over which option – over the muscle or under – will be best for you.
Dr. Laliberte has quickly become one of the most sought-after plastic surgeons throughout Calgary, Edmonton, Canmore, Banff, and throughout Canada for Breast Augmentation because of his unique surgical approach & advanced specialized knowledge in cosmetic & reconstructive breast surgery. Dr. Laliberte will choose varying techniques based on your cosmetic goals and desired surgical outcomes.