Submuscular vs. Subglandular - Which is Better?

I'm worried because my surgery is soon and some have mentioned a rt breast lift is not a good idea or thigh lipo. I heard the chest muscle dies with submuscular placement and that subglandular was better, created better cleavage and filled in the upper pole, so now I'm confused, my surgeon is planning sub muscular, but I called yesterday to see if he does subglandular, any help or suggestions? I'm scheduled to have a tt, rt lift, augment w/ saline 400+cc, lipo on flank, inner/outer thigh. Thanks

Doctor Answers (17)

Depends on your body and goals

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SUB-MAMMARY POCKET (over the muscle)

The implant is placed over the chest muscle, under only the breast tissue.
- good for women with more of their own natural breast tissue so the implant can be hidden better. Also good for tuberous breasts.

SUB-PECTORAL POCKET - Dual Plane (under the muscle) - more common

The top part of the implant is placed under the chest muscle and the bottom third is covered by breast tissue.
-creates a natural teardrop shape. The implant is better covered so it's better for women with less of their own breast tissue. Makes mammograms easier to read.

You should trust your surgeon's suggestion.


Toronto Plastic Surgeon
5.0 out of 5 stars 74 reviews

Submuscular versus Subglandular ? Which is better

+1
Most plastic surgeons seldom perform purely subglandular augmentation for several reasons. Firstly with the incorporation of dual plane techniques over the last 15 years , the advantage that subglandular placement had when there was a bit too much skin excess and the patient wished to avoid a lift has been replaced by this superior technique. In those cases when the implants were placed under the breast alone years later they tend to appear unnatural . With saline implants rippling would become more noticeable and the breast would develop a melon like appearance . When the implant is placed in a submuscular  position the superior pole transition is more natural and there is less chance of distortion over time.  The chance for capsular contracture is greatly reduced and mammograms are easier to perform. It is not uncommon for a plastic surgeon to switch implants from a subglandular to a submuscular  position because of complications, but seldom the other way around.

William F. DeLuca Jr, MD
Albany Plastic Surgeon
5.0 out of 5 stars 118 reviews

Implant placement

+1

Your skin quality is the main determinant of location and so the best person to answer this question is your plastic surgeon. In my practice a majority of women get submuscular implants or dual plane and especially in those women who have lost weight or have a lot of extra skin. The skin has lost volume and elasticity and as such cannot bear the weight of the implant. BTW the chest muscle does not die. That is absolutely false.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 17 reviews

Breast Implant Positioning?

+1

Thank you for the question.

In general, I think it is in your best interests (and that of most patients seeking breast augmentation surgery) to have implants placed in the “dual plane” sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning  also tends to interfere with mammography less so than in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 794 reviews

Breast implants submuscular vs. subglandular

+1

Generally speaking submuscular implant placement is preferred for most patients.  Submuscular implants will not cause the muscle to die.  Advantages of submuscular placement include:

-lower risk of contracture

-lower risk of visible rippling 

Subglandular implant placement is possible in certain individuals, particularly in individuals with a fair amount of natural breast volume.

In your case, I would definitely recommend submuscular implant placement

Andrew P. Giacobbe, MD
Buffalo Plastic Surgeon
5.0 out of 5 stars 14 reviews

Implants below or above the muscle

+1

I would agree with most of the previous posts that submuscular is better for most patients.

The major advantages of submuscular placement include 1) softer coverage, 2) less risk of rippling, 3) improved upper breast shape.

The major disadvantages of submuscular implants are 1) A little more painful recovery, 2) implant movement with activity (this can be minimized by appropriate muscle release).

York J. Yates - Utah

York Jay Yates, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 62 reviews

Sub Muscular versus Sub Glandular Breast Augment

+1

Whenever possible, I prefer Sub Muscular Breast Augmentation. The more of you there is over the implant, the more it will look and feel like you, and the less it will look and feel like an implant. This is especially important in patients who are thin or have very little native breast tissue.

Based on your photos I believe you will do better with a Sub Muscular Augment. Good luck!

Mark Preston, MD
Columbus Plastic Surgeon
4.5 out of 5 stars 11 reviews

Subglandular or submuscular for Breast Augmentation?

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I feel that both positions have a role in Breast Augmentation.  There is no question from the medical literature that the submuscular or dual-plane approach has a lower rate of certain complications such as capsular contracture.  However, there are some disadvantages to this approach as well, including the possibility of breast drooping beyond the position of the implant.

Jeff Scott, MD
Everett Plastic Surgeon
5.0 out of 5 stars 9 reviews

Under or over the muscle with implants - which is better?

+1

There is not really one best answer to this question. The positioning of implants is really left to the patient to select with her surgeon's guidance. My general recommendation is to place the implants under the muscle. The gives a more natural look after surgery, provides a healthy blood supply to surround the implant, and leaves more tissue to cover the implant. In my practice I only recommend that patients who rely on their pectoralis (chest) muscles for a living have their implants over the muscle. I have operated upon body builders, gymnasts, and one trapeze artist who all preferred to leave the muscle untouched. Generally I recommend under the muscle. And in your case I would still recommend going under the muscle.

I hope this info helps!

Adam Rubinstein, MD
Miami Plastic Surgeon
5.0 out of 5 stars 11 reviews

Submuscular versus Saline Breast Augmentation

+1

In your case, you have very little native breast tissue and I would recommend submuscular implant placement.   This will still give you upper pole fullness and cleavage with your breast shape, but decrease your chance of scar tissue formation and rippling in the upper half of your breast.   I find it hard to tell whether you would benefit from a right breast lift based on your photos.   I wish you a safe and healthy recovery.

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 42 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.