What Are the Advantages and Disadvantages of Subfacial and Submuscular Placement? (photo)

Implants placed below the muscle have more tissue above, is less likely to thin out the breast tissue and has a natural appearance at rest.  It also has a slightly smaller chance of capsular contracture.  However, when the muscle contracts during exercise, it will distort the appearance of the breasts which some women find disconcerting.  There is also the possibility that he breast hangs over the implant if there is any sagging.

When placed above the muscle or sub glandular, a smaller implant can be used and will give a more visible result because the muscle isn't in the way.  If properly sized, it can appear very natural because its in a more natural position and will not distort with exercise.  However, there is a slightly higher chance of a capsular contracture and if its too big of the tissue then the breast tissue and skin can be significantly thinned out by the tension and pressure applied. 

When properly sized and placed by an experienced plastic surgeon, both can give a natural result and have a minimal chance of complications. You should make clear to your surgeon what your goals are and how you would like your breasts to appear.  Bringing photos of what you think you would like your breasts to look like helps.  Although that exact look can't be guaranteed, it will help communicate to your surgeon better what you want.

It's a great question. I strongly prefer under the muscle implants because the muscle provides another layer of camouflage for your implants. The muscle contours the top of the implant to give it a more natural slope and hide rippling of the implant. Implants under the muscle have a decreased risk of scar tissue forming around the implant (capsular contracture).  Also, breast cancer screening with mammography gives better images of breast tissue when implants are placed under the muscle. Although an implant on top of the muscle can be a good choice for some women, for very thin women there is not enough camouflage for the implant to look natural. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide if breast augmentation is right for you.

Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity