Subfascial placement of the implant?

Would subfascial placement of the implants be a good alternative when you have a bit sag and alot of breast tissue ? large breasts.. c-cup. Doctors have said that i cant have under the muscle because of my amount of breast tissue. ( it would cause a double bobble) so its either over the muscle or subfascial. i would like to know more about fascial placement please, how it would work on big breasts ? with sag? so..big breasts with sag, over the muscle or subfascial? thank you for your answer!!

Doctor Answers 5

Subfascial placement of the implant?

There are many ways to insert breast implants. They can go on top of the muscle, behind the muscle, or behind the fascia which covers the muscle. Those placed behind the muscle are actually behind the breast too in the lower outer aspect of the breast because the pectoralis muscle does not extend that low.

You can have an excellent result with either behind or in front of the muscle, but behind the muscle has a higher incidence of encapsulation. If there were a perfect way to insert implants, that would be only one way.

Each technique has its advantages and disadvantages. In your case, from your description, you have a fair amount of breast tissue and you have sagging. Typically, in these cases, the patient does best with breast implants plus an uplift (mastopexy). I would not personally choose the subfascia as the optimal location for an implant. The fascia is too thin and will not support an implant.

Your best bet is to seek a plastic surgeon with lots of experience with implanting breasts that sag. If your nipples are lower than your inframammary crease, you will need an uplift. Typically, this is a basic rule amongst plastic surgeons certified by the American Board of Plastic Surgery. Of course, there are exceptions.

I suggest that you not go too large if your breast are already fairly large. More weight will result in earliest sagging in the future. Best of luck to you.

Pocket placement

With the amount of breast tissue you have I would think that placing it under the breast tissue would be the best.I would not see any advantage going under the facia.

Robert Brueck, MD
Fort Myers Plastic Surgeon
5.0 out of 5 stars 54 reviews

Subfascial placement of the implant

You will probably get differing answers from different surgeons regarding the efficacy of subfascial implant placement. The thickness of the fascia also varies from individual. It is hard to predict if this can support an implant. It can be quite thin and weakened as it is elevated to allow placement of an implant underneath it. If you have stretch marks or poor skin tone you may see accelerated sagging of your breasts from the weight of the implant. I prefer placement sub muscularly when possible.

Subfascial placement of the implant

Hard to say without seeing you but it sounds like you need an implant with a breast lift. If that is done then the implant can be placed under the muscle and your breast repositioned higher to avoid it from looking odd.The fascia is quite thin and will not support the implant much. I will eventually fall and cause further sagging like an implant on top of the muscle.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 reviews

Implant placement

You have gone to a good doctor who has advised you well.
The difference between the two is minimal.
It sounds like you are in good hands.
If it were me I would go with that doc and not worry about it.

Richard Sadove, MD
Gainesville Plastic Surgeon
4.8 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.