Subfascia vs submuscular placement?

Hello,
Subfascial placement would be the best option for you to not have deformity or muscle animation when being active. Great job for staying on top of your mammograms! Best of luck.
All the best,
Dr. Joe

I always recommend below the muscle as this has less problems long term. A properly done dual plane submuscular pocket should not have any animation deformity. I would go see a board-certified plastic surgeon (with 6 year integrated plastic surgery training and 1 year The Aesthetic Society accredited fellowship).

Breast augmentation is often performed to replace volume lost from weight loss, breast-feeding, or age or to increase the size of the breast for aesthetic reasons. The implants are most often placed under the pectorals muscle (sub muscular) or over the pectoris muscle (sub glandular). Sub-facial placement is a blend of the two procedures. Each position has advantages and disadvantages.

Advantages to sub muscular implants include a lower risk of capsular contracture, lower chance of rippling, better coverage in thin women, and perhaps a more natural (flatter) upper pole contour. Implants placed under the muscle can, however, be squeezed by the contraction of the pectorals muscle causing movement of the breast when flexing the pec muscle (animation deformity) – especially in very athletic women.

Completely sub muscular augmentations are rare as the space available for inserting an implant is small. Often the bottom edge of the muscle is cut and the implants are only partially covered by the muscle. This preserves a natural transition in the upper pole but allows for a larger implant. This is referred to as a dual plane augmentation.

Implants placed over the muscle, in contrast, are more visible. This can manifest as a larger looking augmentation and a sharper transition between the natural breast and the edges of the implant resulting in a more rounded, done look. Additionally, in thin women with little breast tissue, the folding of the implant in the sub glandular pocket can manifest as rippling of the skin. Sub-glandular implants do not move, however, with flexing of the pec muscle.

Sub-facial placement of an implant is much less common option that places the implant under the thin tough tissue that covers the surface of the pectorals muscle. Sub-fascial placement will decrease the risk of muscle flexion distortions (animation deformity), and provide a flatter, more natural upper breast contour. The sub facial location is not a natural separation between the tissue layers, however, and so the dissection is more traumatic than other options.

The choice of implant positioning depends on exactly how much breast tissue you have, what size and type of implant you choose, and what you desire for your final look. A detailed examination will help delineate the best surgical option.

Hello, thank you for your question. There are benefits of each, Typically a sub muscular plane provides more support to hold the implant upwards and slows down the drooping affects of gravity. It also has a lower risk of capsular contracture and if you don't have much breast tissue typically under the muscle will help disguise some rippling. Speak to your plastic surgeon about your concerns, if you don't want the animation deformity its definitely something to discuss.

Placement of breast implants under the muscle helps prevent rippling and palpability of the implant. It is also easier to see the breast tissue by mammogram when the implants are below the muscle. With thin woman and not a lot of breast tissue, an animation deformity can occur. When a woman flexes her pectoralis muscle, the muscle tightens and you can see the edge of the muscle. If this is of concern, I would suggest you go subfascial realizing the downsides to this pocket placement.

Subfascial breast augmentation would prevent the formation of animation deformity, which can happen any time the implant is placed under the muscle (implants under the muscle always animate somewhat, it's just a question of how badly and how much it bothers you). Whether it's a better choice overall depends on a number of factors which would best be determined in a consultation.

Yes subfascia or sub-glandular placement it will be better option in your case, you will be in the gym sooner, also your bred look more like a breast and not like a male chest, do it subglandular it’s my opinion

Dear Warmhearted720054,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

To avoid as much muscle flexion, the subfascial plane might be best. Not all surgeons do this placement.

I would suggest a simple sub-glandular breast augmentation in view of the fact that you have sufficient breast tissue … this plane will deliver a natural result and will not interfere with chest muscle movement/exertion.