Do sub-fascial breast implants drop and fluff like subglandular or submuscular?

Thank you for your question. Drop and fluff refers to post-operative period in which the breasts begin to descend and fills out the lower half of the breast. It may take several months for this to happen and can be encouraged with breast massage and compression. It may appear that the breast enlarges as the lower aspect of the breast fills out (at the expense of the upper portion of the breast). Under the muscle placement may undergo the most change, but this still occurs with subfascial or subglandular pockets.

...between plane of placement and downwards displacements, it depends more on the texture and its ability to attach to the ribcage.

Thanks for your inquiry.  Your implant shape and size selection will have a lot to do with the final result.  As a small breast woman I would recommend submuscular implants to reduce rippling, palpability.  

Thank you for the question. In my experience, the postoperative changes (drop and fluff) seen with breast implants placed in the sub glandular (or sub fascial) position are generally less striking than breast implants placed in the sub muscular (dual plane) position. Nevertheless, I think that it is important for patients undergoing breast augmentation surgery ( regardless of positioning of breast implants) to be aware that it may take 3 to 6 months for them to see the final outcome of the procedure performed. I hope this, and the attached link, helps. Best wishes.

Despite the marketing hype related to sub facial breast augmentation, many us have always performed sub glandular breast augmentation in a subfascial fashion. Subfascial simply means that the layer of tissue covering the muscle is lifted with the breast glandular tissue above it when creating a sub glandular pocket. Traditionally, many surgeons used a blunt technique to lift the gland off the muscle, and the natural plane of separation was above the fascia. For surgeons who use a controlled approach with electrocautery to develop the pocket and minimize bleeding, it is a routine matter to lift the fascia off the muscle with the glandular tissue to create the pocket. The benefit of this is a more controlled method of creating the pocket, with less bleeding and risk of hematoma, and a slightly thicker tissue layer to cover the implant. If you are extremely thin, it is still recommended that you place the implants under the muscle to have more padding over the implant; but if for any reason you do choose a subglandular approach, like closer implant placement for more cleavage, then definitely I prefer creating the sub glandular pocket in this subfascial plane. The main disadvantage of sub glandular placement is the higher risk of capsular contracture, and there is no evidence that sub glandular subfascial placement has any benefit over traditional suprafascial subglandular placement in this regard.

With the exception of breast reconstruction after mastectomy in my opinion breast implants should be placed in the subglandular space.  This keeps implant volume and native breast volume in the same envelope.  Implants placed under the muscle are separated from the natural volume of the breast which can cause a few problems:1) "Double-bubble" contour related to an implant fullness high on the chest with breast tissue drooping off below the implant;2) Abnormal breast movement and distortion when the muscle is used (in the gym, on the beach, serving a tray of food, shaking hands, etc.).Under the muscle placement is used when there is so little native tissue that edge effects (rippling and wrinkling) may be more prominent, but in the modern era with latest generation gel implants this argument is moot.  Since all implants now carry a warranty for capsular contracture the argument that sub-muscular placement protects against hardening is also very weak.Sub-fascial placement is not used very much: it has the potential to cause the same separation issues as sub-muscular placement but adds little to the coverage of the implant.  It is much more painful (since the muscle is denuded of its facial cover) and in my experience is of little utility.