Is it OK to put form stable implant (Natrelle 410 or Mentor CPG 313), under muscle? What's the best place for this type? (Photo)

Thanks for your question.  There is a wide range of use of the form stable implants; some surgeons use them for most cases but others just use them in certain scenarios. I personally use them only in selected cases when there is some nipple sagging and I want to impart a more perky look, or for tuberous breast correction.

Hello and thank you for your question.  It is very safe to place these implants under the muscle or in a dual plane.   There are several advantages
and disadvantages to over vs under the muscle.  Under the muscle has the
advantage of lower capsular contracture rates, less risk of rippling, and
better visualization with future mammograms.  Most patients say that under
the muscle also has a more natural look and feel.  The size, shape,
and profile of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality. 
This decision should be based on a detailed discussion with
equal input from both you and your surgeon.   Make sure you specifically look at before
and after pictures of real patients who have had this surgery performed by your
surgeon and evaluate their results.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Not only is it ok, but I think dual plane placement of implants is almost always better, regardless of the implant type, as it provides more soft tissue coverage, a smoother transition zone on the upper chest, and a lower capsular contracture rate (more important with smooth implants, but still better).  There is a natural plane of dissection under the muscle that will relax over time when the implant is in place.  To answer your other question, dual plane refers to having pectoralis muscle coverage of the upper / inner part of the implant whereas the lower / outer part of the implant is covered by just the breast tissue, subcutaneous fat and skin.  Different types of dual planes refer to different degrees of dissection of the overlying breast tissue off the muscle.  (If you are very interested, you can find dual plane articles written by Dr. Tebbetts online).  Almost nobody does a true "sub-muscular" placement as this requires lifting the rectus and serratus muscles for full muscle coverage.  When surgeons and patients refer to "submuscular" they are almost always referring to what is more correctly called a dual plane. Hope that helps!

Form stable implants can be placed above or below the muscle. I prefer to place most implants under the muscle because of better soft tissue coverage.

Forms table implants can be used over or under muscle.  There are pros and cons to each approach, that have to be discussed with a patient prior to making a decision.  There's no black and white answer to the questions.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. 

Hello and thank you for your excellent question. Yes, form stable / shaped / gummy bear implants are still placed in a submuscular, or dual plane position. There is plenty of space under the muscle for the implant. With regards to the difference between implant manufacturers / types of implants, each major implant manufacturer (Allergan, Mentor, Sientra) has their own form stable implant. In general, the manufacturing technique and shapes are slightly different between manufacturers, but the implants are largely the same. Some surgeons have a preferred implant that they use, but there is not much good data to suggest one implant type over another. If you want to see and feel the different implants, just to educate yourself regarding your options, I suggest you call around to see which implants different offices offer. The size, profile, shape, texture, and type of implant (e.g., saline, silicone gel, “gummy bear”) is based on your desired versus existing breast size and shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 

Best,

Jon Ver Halen, MD FACS 
Harvard educated plastic surgeon