Over the muscle or under the muscle?

Posted October 31, 2013 by

This is part four a five post series on the top 5 questions to ask during a breast enhancement consultation.

Technically, there are several possible implant locations:

1) Subglandular, retromammary, prepectoral are all synonyms for above the pectoral muscle but beneath the breast gland. This placement afford the most natural breast shape at the expense of support and coverage of the implant. Recovery is generally fast.

breast implant over or below the muscle

            2) Subfascial placement is above the pectoral muscle, yet below the white fascial covering of the muscle. This approach affords better coverage and support than the subglandular; yet better shape than the submuscular.

3) Partial submuscular placement is a very common technique involving the implant resting deep to the pectoral muscle while becoming subglandular below the level of the pectoral muscle. This placement results in better coverage of the implant only in the upper portion of the breast and results in significantly more discomfort than the above procedures. Further, the final breast shape tends not to be as natural as the above procedures – indeed, the breast was never designed to be both above and below the pectoral muscled. Muscle action on the implant will be different than the natural flow if the breast with gravity and movement and can lead to the appearance of a “dancing breast.”

4) Total submuscular placement adds muscular coverage over the entire implant. This is the most effective way of concealing the implant in very thin and thin-skinned patients. However, breast shape is not optimal.

Obviously, if there was one ideal way to place the implant for all patients, all surgeons would use that same method every time. At Anderson Sobel Cosmetic Surgery, we use all the above approaches as each patient has different needs and desires.

More from our 5 part breast augmentation blog series:

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