Is there any benefit to having implants placed under the fascia? Or should I just go sub-muscular?

The term "Under-Fascia" refers to a technique in which the Breast Implant is placed over the pectoralis muscle but under a thin layer of tissue called fascia, which is essentially the "casing" over and around the muscle. Fascia is conceptually like the casing that holds a sausage together, and effectively keeps all the muscle fibers together. Fascia is very thin and is difficult to lift off of the muscle. I believe the goal is to support the implant with the cover of fascia, but the ligaments of the breast are a more natural support. In your case a sub-fascial placement would be equivalent to a sub-glandular breast augmentation. "Under Muscle" augmentation does cover the Breast Implant with more tissue to soften the contour of the implant somewhat, and also improves mammogram evaluations in most women and may decrease the risk of capsular contracture. Please review your options with your plastic surgeon to determine what is best for you!

Dear tsjx_,

You question is an excellent one. Particularly for thin, athletic women such as
yourself, the perception of submuscular implantation, although excellent for
camouflage and blunting the chest wall implant take-off, there can be some
motion of the breast implants during pectoralis major and upper pectoral girdle
exercises. The subglandular placement
relies on an individual with a health amount of subglandular tissue, she has a
C cup and the use of cohesive gel implants.
There is still a higher risk of visible ripples with subglandular
placement, even with adequate glandular tissue, and some physicians will elect
to place a subfascial implant. This is
quite controversial. Some plastic
surgeons feel there is very little benefit to the subfascial placement in terms
of the presence and visibility of ripples.
With the newer cohesive gel implants, this distinction of subglandular
and subfascial has become less important. If you are seeking cohesive gel
implantation, I would recommend a high dual plane pocket, as this will provide
the blunting of the upper pole to avoid that “Posh Spice” bubble breast
look. It will still give you adequate
camouflage and you rely on your subglandular tissue in the lower pole of the
breast.

I have been performing breast augmentation surgery for almost
20 years and the use of the Vectra 3D® will help you decide very accurately on
the size and shape that best suites your athletic figure, shape and form and
then the pocket decision will be one selected between you and your operative
surgeon.

In my experience, athletic women generally have to compromise
being completely comfortable with the submuscular, dual plane position while
they’re working out versus being very happy with the submuscular plane when in
non-athletic circumstances, such as a bikini, cocktail dress, a tank top or
when topless.

For more information, please review the link below.

I hope this information has been of some assistance and best
of luck.

Sincerely,

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon