Breast Augmentation with Breast Implants is a very popular and common Plastic Surgery procedure. If you are considering having Breast Implants there are many decisions that you will have to make with the help of advice from your Plastic Surgeon. You will have to choose the size and style of Breast Implant, where you want your incision, and whether you want your Breast Implants placed over the chest muscle (see above Before and After Photo) or under the chest muscle (see Below Before and After Photo.)
The major muscle on your chest is called the Pectoralis Muscle and there are two of them, right and left. Breast Implants may be placed beneath the muscle, and this technique is called a Subpectoral or Submuscular Breast Augmentation. If the Implant is placed on top of the Pectoralis Muscles, the procedure is called a Subglandular (beneath the breast gland) Breast Augmentation or Prepectoral Augmentation.
To help you decide whether you want a Subglandular or Submuscular Breast Augmentation let’s discuss some of the advantages and disadvantages of both techniques.
Advantages of Subglandular Breast Implants
• Less discomfort
• Quicker Recovery
• Implant falls to normal position more quickly
• Looks better in sagging breast without need for breast lift
Disadvantages of Subglandular Breast Augmentation
• More visible Implant in thin women with little breast tissue
• Breast may sag more over long time
• Folds or Ripples, especially in Saline Implants, may be more visible
• May have higher incidence of firmness long term
Advantages of Submuscular Breast Augmentation
• More tissue covering Implant-less implant show in thin women with little Breast tissue
• Less prone to firmness over long term
• Ripples in Saline Implants less likely to show
• Daily action of muscle provides Implant Displacement exercises
• Some feel a more natural look
Disadvantages of Submuscular Breast Augmentation
• More discomfort
• Longer Recovery
• May interfere with pushups, weight lifting and other exercise
• Visible motion and distortion of Implant with Pectoralis Muscle contraction
• Holds Implant higher thus will need a Breast Lift if you have sagging Breasts
• Need for revision may be more common
How to Decide Under or Over the Muscle
First, you need to have a consultation with one or two experienced Board Certified Plastic Surgeons who are experienced in Cosmetic Plastic Surgery. Visit the website of the American Society of Aesthetic Plastic Surgeons for a list of Board Certified doctors in your area. Discuss you options thoroughly with the Doctor. There will be specific issues regarding your anatomy, lifestyle, and goals which will swing the decision one way or the other.
Also read as much as you can about Breast Augmentation with Breast Implants so you are well informed. Another good source of information is the website of the American Society of Plastic Surgeons.
You and your surgeon will make the final decision however some general guidelines are:
• If you are very thin, with little Breast Tissue and no Ptosis or sagging, the Submuscular approach may be your best choice.
• If you have had children or lost weight and do not want the scars associated with a Breast Lift, and your surgeon feels that you can avoid a lift, then the Subglandular approach may be better for you.
• If you participate in vigorous physical exercise such as weight lifting and pushups and visible motion of your implants will bother you, then the Subglandular approach may be better for you.
• If you are primarily concerned about avoiding capsular contracture or firmness of your implants the Submuscular approach may be best for you.
• If you must have Saline Implants and are concerned with folds or ripples then the Submuscular approach would be better.
• If you want a quick recovery and are concerned about pain or discomfort the Subglandular approach may be better for you.
What is Most Important?
Both Subglandular and Submuscular Breast Implants can provide Beautiful Results and have done so for hundreds of thousands of women. The key is the experience and skill of your Plastic Surgeon. Your choice of a Plastic Surgeon will be the most important factor in your decision.
See more than one doctor, make sure they are certified by the American Board of Plastic Surgery and that they are an expert in Cosmetic Surgery of the Breast. Try to find friends who have had this surgery and ask them about their surgeon. Be sure you feel confident in and comfortable with the doctor who you choose.