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

Dear tsjx_Thank you for your question!The breast implant placement will depend on your preference,and  the surgeon performing the surgery .When the implant is placed below the muscle- with muscle flexion- push ups, working out etc- the implant will be compressed by the muscle and will move to some degree in an upward , outward direction ( even if completely under the muscle. if the implant is placed in the sub-facial plane (under the gland)- in most cases , will give a very natural result.  Fat grafting can be performed at the same time to shape the area around the implant if needed (allowing that you have fat that can be used!)With Warm RegardsTrevor M Born MD

Fascia covering pectoralis muscle is very thin and does not provide any benefit over subgladular placement and may cause more bleeding that can lead to capsular contractures. I place all the implants in submuscular pocket (dual plane) this procedure has many benefits mostly better coverage of the impl,ant and less chance for a capsular contracture

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!

Generally speaking, you will find that the most important decision/selection will be that of your plastic surgeon, not the precise “pocket” or procedure…  I would recommend that you select your plastic surgeon based on ability to achieve the outcome you are looking for. Then, allow him/her to use his/her experience and expertise to achieve your goals. Selecting a plastic surgeon based on techniques utilized and/or trying to “micromanage” a plastic surgeon's technique is not a good idea, in my opinion.  In my practice, I would likely suggest the use of the sub muscular (dual plane) position for most breast augmentation patients. Best wishes.

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

Thank you for your question.  I honestly recommend that you choose the best board certified plastic surgeon you can find and follow the recommendations of your chosen surgeon.  Submuscular breast augmentation has many advantages and has been used for a very long time successfully.  Subfascial is a newer technique and depends on adequate preservation of the fascia which is a very thin layer.  If there is a break in the fascia then essentially implant is Sub-glandular.Again I recommend that you concentrated on finding the best surgeon to do your breast augmentation and follow that surgeon's advice with the technique that he or she uses.  A good place to start you search is the Smart Beauty Guide which is available online.