Is subfascial breast augmentation a common placement?

Pictures would be very helpful in this case.  However, If you have saline sub glandular implants, I would certainly think that, in most cases, switching to silicone gel implants alone will almost always improve the quality of the result.  If you are lacking upper pole fullness, a wider implant may provide this for you.  Subfascial placement is an excellent first-time sub glandular pocket option that I perform often.  However, if you already have a sub glandular pocket, you probably cannot switch to a subfascial pocket at this time because the tissue layer will likely be too thin.  Switching to a sub muscular pocket is advisable if you are seeing rippling or having trouble with capsules, but otherwise may not be necessary..  

Thank you for this great (and concerning) question regarding subfascial breast implant placement.

First, let's talk about what fascial tissue is. It's the thin and very fibrous connective tissue that surrounds muscle throughout the body, including the pectoral muscle in the chest. Fascial tissue helps bundle muscle groups, blood vessels and nerves. Anyone who has ever skinned a chicken has seen fascial tissue. It’s that thin and amazingly stubborn layer of grizzly membrane over the muscle and meat. Similarly, in human anatomy, muscle and fascia are bound together. Attempts to separate the fascia and tissue to introduce an implant would be traumatic and ultimately ineffective.

When I review medical literature on subfascial placement (and there is very little - another warning sign) the supporting photo documentation often shows a pectoral muscle incision. The bottom line: the FDA, professional surgical associations, implant manufacturers and the vast majority of information in implant literature do not even mention subfascial as a viable breast implant placement option. Buyer beware.

While every patient and surgery is unique, Mandeline, your concerns do suggest submuscular might be the optimum placement option. As always, seek out only an experienced, board-certified plastic surgeon who can best deliver on the outcome you desire. I urge you to think twice about subfascial recommendations. It’s more marketing buzz than it is good medicine.