Subglandular silicone implants advantages and disadvantages.

what are the disadvantages of subglandular implants ? My surgeon insisted on putting the implants subglandular and not submuscular, and I'm so afraid of that !

Doctor Answers 12

Subglandular vs Submuscular

Thank you for your question and photos. There are several key differences when comparing a sub-muscular pocket to a sub-glandular pocket notably the higher rate of capsular contracture with the sub-glandular pocket position. There may be advantages for certain patients when going over the muscle or subglandular notably a quicker recovery time, better lift effect on the breast and no animation with pectoralis activation to name a few. The partial submuscular pocket will better hide any rippling on the implant, cause less capsular contracture and perhaps have a lower rate of infection. I wish you the best in finding the right answers as there are a lot of great answers and information on this forum. Remember, it is best to see a Board Certified Plastic Surgeon who can in person examine you, take key measurements and go over with you your specific aesthetic goals. Bringing several photos of your "ideal" look can be helpful as well.  

Best of luck,

Benjamin J. Cousins M.D. Board Certified Plastic Surgeon

Miami Beach Plastic Surgeon
5.0 out of 5 stars 10 reviews

Subglandular silicone implants advantages and disadvantages.

Thank you for your question.  When possible most surgeons placed breast implants underneath the chest muscle the pectoralis muscle.  The advantages of placing the implant under the muscle are better coverage of the implant,  and less risk of capsular contracture or hardening.  In patients who have larger breast with significant breast gland tissue present subglandular implants can be covered with the breast tissue.  Breast implants placed under the muscle can move with contraction of the muscle and some patients  prefer not to have this movement and request implants under the breast gland.

Subglandular silicone implants advantages and disadvantages

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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Saline vs silicone, some advices:

Thank you very much for this interesting question.
In my practice i recommend using - Cohesive Gel - Silicón Breast Implants with textured cover.
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 270 reviews

Subglandular silicone implants advantages and disadvantages.

Thank you for the question.  

There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.    I will try to outline some of the differences here;  you may find the attached link helpful as well. I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or 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).  I think that breast implant placement in the sub glandular position (over the shorter or longer term) tend to be associated with more problems with visibility (rippling) or palpability.  Basically, the more coverage we have overlying breast implants, the better the long-term look/feel seems to be. 

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

On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle)  that can be seen with breast implants placed in these sub muscular position.    


 I hope this (and the attached link/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The best way to determine implant size is based on chest wall measurements that fit your body.  Once we determine that we can choose the profile based on what you want or need to achieve.  

Implants under the muscle, there is less risk of capsular contracture.  Anatomic implants tend to give a more natural shape with more nipple projection.

The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

Director-Beverly Hills Breast and Body Institute



Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Subglandular implants

My preference is submuscular. Subglandular in thin patients are more prone to visibility and rippling.  Also there may be a slight increase risk of capsular contracture.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Sub glandular

This is a totally acceptable way of doing it. Submuscular is only PARTIALLY UNDER the muscle. Half to one third are still under the breast. Also I don't believe those who say there are less capsules under the muscle. In my practice it's equal. Saline does better under the muscle due to rippling - silicones are great over. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Subglandular implants

Over the muscle looks more natural and maybgive more lift. It is also an easier recovery and useful in body builders. Higher fill gel implants can be used in thinner patients. Some increased risk with capsule contracture may result.

An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Harry T. Haramis, MD, FACS
Montclair Plastic Surgeon
3.7 out of 5 stars 19 reviews

Subglandular vs submuscular implants

The majority of doctors prefer submuscular because there is a lower incidence of capsular contracture, ie stay softer longer, they look and feel more natural, and they assist the radiologist when evaluating mammograms as the muscle covers a good portion of the implant and separates it from the breast tissue.

The advantage of subglandular, is you get more lift if needed, and less discomfort postoperatively. You also do not get the implants moving when working out the chest muscle.  The disadvantage is depending on the amount of breast tissue and fat you have, they may look less natural.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 22 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.