There are advantages and disadvantages to both that must be understood for an intelligent decision to be made. First of all, as by other doctors, present day opinion (without scientific validation) favors a submuscular placement when considering the interpretation of mammograms. It is debatable that this is a major consideration. The placement of your implant will be determined during consultation with your doctor or physician.
If a breast is tubular in shape or if it is modestly ptotic (droopy), there is a definite aesthetic advantage to placing the implant above the muscle. The ultimate shape is more natural when the implant is in this subglandular position.
As a rule, since saline implants are filled with water and not thicker silicone gel, they feel more natural when more tissue covers the implant. Women who have some breast volume to begin with can expect a more natural feel to the breast.
Consequently, saline implants are preferred deep to the pectoralis muscle all other variables being equal. More tissue covers the implant (the pectoralis muscle is another layer of tissue) making them feel somewhat more like normal breast tissue. A submuscular implant may be distorted when the pectorallis muscle is being used. During certain strenuous chest exercises such as swimming or weight training, the implant may be temporarily misshapened as the pectoralis muscle is exercised. This is very subtle and seldom a problem for our patients.
Submuscular placement does not involve cutting of any muscles and does not diminish muscular strength. Patients comment that post-operative pain is greater in the submuscular position. This generally equalizes with the subglandular placement in a few days, but is a consideration, nonetheless. After the appropriate convalescence, it is permissible to resume the normal range of activities.
