What Are the Advantages and Disadvantages of Subfacial and Submuscular Placement? (photo)

Subfascial augmentation is a very misunderstood procedure.  Those that are inexperienced or ignorant say it is a farse or the same as subglandular, but this is the farthest thing from the truth.  Subfascial is the only technique that can provide true shaping support from within the breast and maintain a dissociation from the pectoralis major muscle minimizing implant movement of 'animation.'

 

I find the fascia so crucial in creating a beautiful breast shape that I developed something called the 'cold-subfascial augmentation' which preserves all of the fascia and allows precise shaping of a breast to fit the individual patient.  Dual plane implants are plagued by lateral displacement, bottoming out and muscle jumping or animation.  I hope this helps!

 

All the best,

 

Rian A. Maercks M.D.

It's a great question. I strongly prefer under the muscle implants because the muscle provides another layer of camouflage for your implants. The muscle contours the top of the implant to give it a more natural slope and hide rippling of the implant. Implants under the muscle have a decreased risk of scar tissue forming around the implant (capsular contracture).  Also, breast cancer screening with mammography gives better images of breast tissue when implants are placed under the muscle. Although an implant on top of the muscle can be a good choice for some women, for very thin women there is not enough camouflage for the implant to look natural. When considering breast augmentation make sure you find a board certified plastic surgeon who will take the time to answer all of your questions and explain all of your options, so that you can decide if breast augmentation is right for you.

Submuscular placement may be more uncomfortable the first few days following surgery. The possible benefits of submuscular placement are that it may result in less palpable implants, less capsular contracture, and it will make it easier to image the breast with mammography. The appearance may be more “natural” for patients who are very thin. Subglandular placement may make your surgery andrecovery shorter and you may have less discomfort. This placement may provide a slight “lift”. Subglandular placement may result in more palpable implants, more capsular contracture and more difficult imaging of the breast with mammography. This placement is often recommended for those patients with sagging, but do not want a breast lift (mastopexy) and for tubular breast deformity