Subglandular silicone implants advantages and disadvantages.

Question

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 !

Larry S. Nichter, MD, MS, FACS · Answer

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

Emmanuel Mallol Cotes, MD · Answer

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.-

Jaime S. Schwartz, MD, FACS · Answer

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. SchwartzBoard Certified Plastic Surgeon

Director-Beverly Hills Breast and Body Institute

#RealSelf100Surgeon

#RealSelfCORESurgeon

Harry T. Haramis, MD, FACS · Answer

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.

Daniel Sherick, MD · Answer

I see that the other physicians have generated a very comprehensive list for you of the pros and cons of subglandular implants.  The one issue I see missing is the decreased risk for "animation deformity."  Although this is not always a problem, some patients develop a great deal of breast distortion with implants in the submuscular position, when they contract their muscles.  This does not occur when the implants are subglandular.  Neither position is the right placement for every patient.  I hope you like your implants.

Adolfo Sesto, MD · Answer

Subglandular SIlicone Gel Implants Vs. Submuscular Placement. To be or not to be......In my 23 year practice i prefer the submuscular placement for its natural look and the avoidance of displacement of the implants. I do not find any advantages for my patients to place them subglandular, the advantages will be only for me for its easier technically for the PS to locate them in a subglandular pockett. This placement will result in a very unnatural look and a earlier dropping of the breast tissue.

Tom J. Pousti, MD · Answer

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.

Steven Wallach, MD · Answer

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.

Benjamin J. Cousins, MD · Answer

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

Board Certified Plastic Surgeon

William B. Rosenblatt, MD · Answer

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.

Subglandular silicone implants advantages and disadvantages.

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