Athena Vale
When considering breast augmentation surgery, one of the decisions to be made is whether to place the implants over or under the chest muscle. The choice depends on several factors, including the patient's body type, the amount of natural breast tissue, implant type and size, as well as the patient's aesthetic goals. Subglandular placement, or over the muscle, involves positioning the implant between the chest muscle and the breast tissue, under the breast's glandular tissue. This method is less invasive, has a shorter recovery time, and is suitable for those with ample breast tissue seeking a natural-looking enhancement. On the other hand, submuscular placement, or under the muscle, involves placing the implant under the pectoralis major muscle, offering more coverage and a more natural contour, especially for those with little natural breast tissue. This method may result in a longer recovery and potential discomfort, along with the possibility of implant distortion during chest muscle contraction.
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What You'll Learn
More natural-looking results, especially for thin patients or those with little natural breast tissue
When considering breast augmentation surgery, one of the important decisions to make is whether to place the implants over or under the chest muscle. This decision is influenced by various factors, including the patient's body type, natural breast tissue, and aesthetic goals.
For thin patients or those with little natural breast tissue, placing implants under the muscle can result in a more natural-looking appearance. The pectoralis muscle covers the implant, providing effective padding and creating a smoother transition from the chest wall to the implant. This technique reduces the risk of visible rippling, wrinkling, or folding, which is more likely to occur when there is less natural tissue to hide the implants.
Submuscular placement, or "under the muscle", involves positioning the implant underneath the skin, fat, glands, and pectoralis major muscle. This placement provides more tissue coverage over the implant, particularly in the upper pole, resulting in a more natural contour. It is important to consider the position of the natural breasts in relation to the muscle, as implants placed under the muscle can appear unnaturally high if the natural breasts have sagged due to age or other factors.
While subglandular or "over the muscle" placement can also provide natural-looking results, it is generally recommended for patients with ample breast tissue. In this technique, the implant is placed under the breast's glandular tissue, minimizing the risk of implant visibility and distortion during chest muscle contraction. However, thin patients or those with little natural breast tissue may experience implant rippling or reduced implant coverage with this approach.
Ultimately, the decision to place implants over or under the muscle depends on the patient's unique anatomy and goals. A board-certified plastic surgeon will be able to guide patients in choosing the most suitable placement technique to achieve their desired results.
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Reduced risk of capsular contracture and implant rippling
When considering breast augmentation, one of the important decisions to make is whether to place the implants over or under the chest muscle. This decision is based on several factors, including the patient's health history, implant type and size, body type, age, current breast anatomy, and activity level.
One of the benefits of placing implants under the muscle is that it reduces the risk of capsular contracture. Capsular contracture is a condition where scar tissue forms around the implant, causing the tissue to tighten and harden, which can be painful. It can occur after any medical implant but is particularly concerning in breast augmentation as it can alter the appearance of the breasts. Placing implants under the muscle can lower the risk of capsular contracture from 18% to less than 10% in primary augmentation patients.
Implants placed under the muscle also reduce the risk of implant rippling, wrinkling, or folding. Implant rippling occurs when "wrinkling" is visible on the outer perimeter of the implant, and it is more likely to happen when the implants are placed over the muscle as the upper "edges" of the implants are more easily seen. The chest muscle provides coverage and support for the implants, creating a smoother transition from the chest wall to the implant and achieving a more natural-looking result.
Additionally, the muscle effectively pads the implant, reducing the "step-off" that can occur with higher-profile implants. Women with little natural breast tissue or those who are very thin may benefit from under-the-muscle placement as it provides a more natural-looking result. However, it is important to consider the position of the natural breasts in relation to the muscle, as placing implants under the muscle can sometimes result in an unnaturally high appearance if the natural breasts have sagged due to age or breastfeeding.
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Less interference with mammogram readings
When considering breast augmentation surgery, one of the decisions that need to be made is whether to place the implants over or under the chest muscle. This decision is influenced by various factors, including the patient's health history, implant type and size, body type, age, current breast anatomy, and activity level.
One important consideration when choosing implant placement is the potential interference with mammogram readings. While it is possible to have accurate mammogram readings with either implant placement, the "over the muscle" or subglandular placement may interfere more with the visibility of breast tissue during the mammogram. This is because the posterior tissue of the breast can be blocked from view, potentially obscuring important findings.
On the other hand, "under the muscle" or submuscular placement provides more tissue coverage, which can improve the visibility of the breast tissue during a mammogram. The pectoralis muscle covers the implant, creating a smoother transition from the chest wall to the implant and reducing the risk of visible rippling or wrinkling. This increased tissue coverage allows for better imaging of the breast tissue and can result in more accurate mammogram readings.
It is important to note that regardless of implant placement, women with breast implants should still undergo regular screening mammograms. Mammography technologists are trained to work around the presence of implants, and additional images, known as implant-displaced views, can be taken to ensure a comprehensive evaluation of the breast tissue. These extra images involve pushing the implant back against the chest wall and pulling the breast tissue forward, allowing for better visualisation of the tissue and reducing the risk of missing any potential abnormalities.
In summary, while both implant placements are compatible with accurate mammogram readings, "under the muscle" placement may offer a slight advantage in terms of reduced interference with mammogram visibility and improved detection of breast abnormalities. However, the decision on implant placement should be made in consultation with a qualified healthcare professional, taking into account the patient's individual needs and preferences.
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Longer recovery time and more post-operative discomfort
Breast implants placed under the muscle can result in a longer recovery time and more post-operative discomfort. During the procedure, the pectoralis muscles are split, which can lead to increased pain and a longer recovery period. This technique is more invasive than placing implants over the muscle, as the chest muscle is manipulated, and this can result in more discomfort for the patient.
The level of post-operative discomfort and recovery time can depend on the patient's body type and unique anatomy. For instance, women with large and/or strong chest muscles, such as athletes, may experience more distortion with under-the-muscle placement. This is due to the implants shifting when the chest muscles are flexed, which can cause the implants to look unnaturally high on the chest.
In contrast, women with little natural breast tissue or those who are very thin may be better suited to under-the-muscle placement. The muscle provides coverage and support for the implants, creating a more natural-looking result. Additionally, submuscular placement can reduce the risk of capsular contracture and rippling.
It is important to note that the decision of breast implant placement should be made in consultation with a board-certified plastic surgeon, who can guide patients in choosing the most suitable option for their individual needs and goals.
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Higher risk of implant distortion
Breast implants can be placed either over or under the chest muscle. The placement depends on various factors, including the patient's health history, implant type, implant size, body type, age, current breast anatomy, activity level, and tolerance for post-surgery downtime.
When implants are placed under the chest muscle, or submuscular placement, there is a higher risk of implant distortion. This occurs when the chest muscle contracts, squeezing the implant underneath and changing its shape and appearance temporarily. This distortion is known as dynamic distortion or animation deformity. It is more likely to occur in athletic individuals who engage in upper-body workouts before the tissues are completely healed, as the implants may be pushed into the armpits or strange positions. However, it is important to note that dynamic distortion does not cause any long-term damage to the breast tissue or implant, and the appearance and functionality return to normal once the muscle relaxes.
The risk of implant distortion can be reduced by placing the implants over the chest muscle, or subglandular placement. This method leaves the chest muscle intact, eliminating the possibility of distortion during exercise or daily movements. However, this placement may result in a higher risk of rippling or visible folds and wrinkles on the implant, especially in patients with little natural breast tissue or thinner women with smaller breasts.
To determine the appropriate placement, patients should consult with their surgeon to discuss their individual factors and desired outcomes. While submuscular placement may increase the risk of distortion, it offers improved aesthetics and a reduced risk of complications like rippling. On the other hand, subglandular placement provides a quicker recovery and less post-operative discomfort but may require additional measures to address implant visibility. Ultimately, the decision should be made based on the patient's specific needs and preferences.
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Frequently asked questions
Placing breast implants under the muscle results in a more natural appearance and a reduced rate of capsular contracture.
Capsular contracture is a painful condition where scar tissue develops around the breast implant, causing it to harden.
Women with little natural breast tissue are good candidates for submuscular placement. This is because the muscle offers coverage and support to achieve a natural-looking result.
Submuscular placement causes slightly more post-operative discomfort and a longer recovery time. It can also cause animation deformity, which describes a distortion of the implants while contracting the chest muscle during exercise or some daily movements.
