Breast implants placement

Over the muscle or behind the muscle ? In order to understand implants placement, patients need to know a few things about breast anatomy. Breast are made of several layers : the rib cage, the pectoral muscles, the mammary gland, the subcutaneous tissue and the skin.

A few options are available to breast augmentation patients regarding implants placement :

The submuscular position (« under the muscle »).
The subglandular position (« over the muscle »).
A combination of these two positions : the dual plane technique (a portion of the implant is covered by the pectoral muscle while the other is not).

Breast implants positions : pros and cons

Subglandular placement pros

The implant stays still when the pectoral muscle contracts (the result is natural) with no deformation.
The procedure only causes low levels of pain or discomfort.

Subglandular placement cons

There is a risk of implant contours being visible in skinny patients (a pinch test can assess this risk in the cleavage area).
Implant rippling is also a risk with this position, which can be decreased by using silicone implants.

Submuscular placement pros

The upper edge of the breast implant is covered by the muscle for a more natural looking cleavage.
This position decreases the risk of capsular contracture.

Submuscular placement cons

Breast shape changes when the pectoral muscle contracts.
Postoperative pain is more significant than with subglandular placement but well tolerated by most patients.
When the breasts are slightly sagging, the implant does not follow this motion because it is held in place by the muscle cover.

What about the dual plane placement ?

The upper pole of the implant is well hidden behind the muscle, which offers a truly natural appearance of the cleavage.
The lower part of the implant fills up the skin envelope nicely, which lifts up the areola slightly.
This position offers a very natural evolution over time.
Breast shape is only slightly affected by muscle contractions.
The dual plane position causes less postoperative pain than the submuscular placement.