What amount of breast tissue is preferred for subglandular placement?

Question

I have had a few consults and wondering what amount of breast tissue is preferred to place an implant sub glandular?

William Andrade, MD · Answer

Hello, I think you will find that each surgeon's criteria for tissue thickness over subglandular implants is different, but more coverage is always better.  I personally like to be able to pinch at least 2-3cm of tissue for implants inserted in the subglandular or subfascial plane.  However, the answer is actually more nuanced, because some people have adequate breast tissue thickness yet they have a wide space between their breasts (sternal gap) with little tissue between the breasts.  If a person with this type of anatomy wants me to put the implants closer together to help close the gap, there will be a relatively thin layer of tissue covering the implants in the centre of the chest.  This could lead to visible or palpable implant rippling in the cleavage area.  This is why it is important to have a proper consultation with an experienced breast surgeon to assess your unique anatomy before making a decision.  As you already have been so a few in-person assessments, these surgeons will be your best source of advice.

Richard Baxter, MD · Answer

If the thickness of your subcutaneous tissue is at least 1.5 to 2 cm over the medial and upper part of the breast, then subglandular or subfascial placement should work. Use a more cohesive gel implant for minimizing rippling. If you aren't a candidate for this then look into split muscle, which minimizes animation deformity like you can get with dual plane, but still have muscle coverage over the upper and medial parts of the breast.

Kenneth Hughes, MD · Answer

As a bodybuilder, I augment professional athletes frequently. I think for those people in whom the living is made by athletic performance, the implant can be placed above the muscle. Other patients will be happier long term with submuscular (dual plane). During your consults the plastic surgeons should be able to tell you which implant placement is best for you.

Robert M. Tornambe, MD · Answer

I usually reserve subglandular breast augmentation for women with a modest amount of breast tissue who also have ptosis and deflation, And do not desire a breast lift. The subglandular approach doesn’t work well with really thin individuals that have small amount of breast issue, because the implants become more noticeable. Consult with a board-certified plastic surgeon in your area to explore the best options for you. Good luck.

Daniel Barrett, MD · Answer

Dear annettebw,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Dann Leonard, MD · Answer

Even though your question is quite simple and straight forward, the answer is very complicated. In my practice I rarely do a subglandular augmentation. Most of these patients are quite thin and some muscle coverage helps conceal the implant edges. Subglandular implants are also at a higher risk for capsular contracture.
Dann Leonard, MD

Vivek Sivarajan, MBChB · Answer

Whist the 'classical' answer to this is 2cm of pinch thickness on the upper part of the breast, in my experience of over 1000 breast implant surgeries I far prefer to place implants in a dual plane position, so partly over and partly under the muscle. The advantages of this are that the implant displaces less, maintains its shape better in the long term and reduces the risk of complications such as capsular contracture (hardening of the implants) and rippling.

David Finkle, MD · Answer

This is an age old question and there is no one right answer. There are many variables to consider. The general rule of thumb is that you need 2 cm thickness of breast tissue to camouflage the implant. Please consult with a board certified plastic surgeon who performs breast implant surgery frequently to assure the best possible result.

Good Luck!

Good Luck!

Connie Hiers, MD, FACS · Answer

For subglandular placement, you want enough breast tissue to hide and cover the implant.  Also, I would avoid choosing a large and heavy implant since you will sag over time.  For most women who are choosing a size that fits there frame, they will want to have a full B to C cup already. With anything smaller, the implant will be noticeable and look somewhat like a ball.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and the more breast tissue present the better for subglandular placement but the incidence of capsular contracture is higher there. So go on some consultations with experts and see what placement is best for you after a full examination and discussion of desired results

Dr Corbin

Dr Corbin

What amount of breast tissue is preferred for subglandular placement?

Answers (10)

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