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.