Submuscular vs. Subglandular - Which is Better?

This is a good question as the majority of patient that wish
to have a breast augmentation desire a result that is going to feel and look
natural.



In the United States the vast majority of breast
augmentations are performed under the muscle.
However there are certain situations where the implant is placed over
the muscle. The benefits of placing the
implant below the muscle:1.More natural feel2.More natural appearance3.Less visibility of the implant4.Placing the implant below the muscle also
decrease the chance that the patient will form scar tissue around the implant.5.Less chance of having visible rippling from the
implant.



It is important to see your board certified
plastic surgeon to help guide you to an implant that will give you an
aesthetically pleasing breast.

Implant placement relative to the pectoralis major
muscle continues to be a source of controversy. Although the majority of
plastic surgeons prefer submuscular placement there is still a large group of
plastic surgeons who feel strongly about subglandular placement. Each group can
make convincing arguments regarding their position of choice. It’s safe to say
both approaches have advantages and disadvantages.

In the context of these discussions we feel that every
patient needs to be considered individually. Each patient has unique anatomic
findings that effect the decision to place the implant under or over the
muscle. The aesthetic goals of the patient are equally important and have a
significant impact on the decision as well. The vast majority of patients are
striving for larger breasts with a natural look. They want balance, harmony,
and proportion with the surrounding structures.

The majority of breast implants are placed in a
submuscular position. There are several advantages to this approach. These include
more soft tissue coverage which results in fewer visible folds, creases, and
ripples in the implant. This is especially important in women who have thin
skin and minimal breast tissue who want saline implants. Another advantage of
submuscular placement is a lower incidence of capsular contracture. This
phenomena results in hardening and distortion of the breasts. Patients can also
have significant pain with capsule formation. Capsular contracture can occur
with the implant in either position but the incidence is higher when the
implant is placed on top of the muscle. For these reasons, submusclar placement
gives a more natural look in most cases.

Placement on top of the muscle should be considered in
female body builders who have large muscles which can distort the implant
during contraction. In women with breast sag, implants can be placed on top of
the muscle to avoid a breast lift and scarring.

Every patient should be considered individually. It’s important that you meet with a board certified plastic
surgeon who can help obtain your aesthetic goals.