Comparing Subglandular and Submuscular Breast Implant Placement
The placement of a breast implant has an impact on the final look. You have the option of only two locations. One is behind the skin and breast gland, while the other is behind your skin, breast gland, and the pectoralis major. The first placement is subglandular, whereas the second is submuscular. Both methods have pros and cons, so it’s best to understand them fully. Let’s dig deeper;
Subglandular Breast Implant Placement
This placement is the closest to the usual arrangement of breast tissue. The plastic surgeon uses anatomic landmarks to create a pocket above your breast’s muscular layer. They then insert the implant under sterile conditions. With this placement, the most common incisions are inframammary and peri-areolar.
The inframammary incision is on the crease under the breast, whereas the peri-areolar is at the bottom of the areola’s rim. Most people consider this procedure more aesthetically pleasing as it offers better breast roundness.
Pros
Less recovery time; Subglandular breast implant placement is less invasive than submuscular implant placement. It does not involve deep penetration, which ensures patients have a shorter recovery time. It is possible to undergo this procedure with local anesthesia only.
Better Aesthetics
Easier revision or re-operation surgeries
The best option for athletic or muscular women.
Cons
Subglandular placements are losing popularity due to the number of associated complications and side effects. When the implants are saline, you can get a rippling effect, which is more pronounced with subglandular placement. This is because the implant’s wrinkles are more visible through your skin.
Higher risk of capsular contracture. With subglandular placement, there is a 30% chance that you will get capsular contracture, compared to a 10% in submuscular placement.
The unnatural look; Some people find the roundness achieved with subglandular placement unnatural. Aesthetics are subjective; your best guide will be looking at before and after photos. This will help you decide which results you want.
More challenging imaging during mammograms; Studies show that implants may hinder the breast tissue’s optimal view during a mammogram. When viewed in a standard mammogram, saline and silicone implants appear like white splotches as they are radioopaque. Thus, the doctor cannot view your breast’s entire tissue. Flattening of the breasts may also be difficult due to the implants. This hinders the technician from taking a high-quality image.
With subglandular placed implants, you need more images than those taken in a standard mammogram. This is to increase the images’ visibility. In some cases, your doctor can take “ implant displacement images,” where they push back the implant against the chest wall to bring the natural breast tissue forward.
No need to worry, though; studies show that although the implants can hinder the view of some breast tissue, they do not impede cancer detection and prognosis. However, if this is a huge concern for you, consulting your plastic surgeon could help. They can advise you on a position with the desired aesthetic and optimal view. Whenever you go in for an imaging screening, always remind your radiologist or technician about your implants.
As explained earlier, submuscular placement places the breast implant behind the pectoralis major. This thick, flat muscle covers the chest’s upper front area, below the inner part of the breast gland. The pectoralis major covers a wide area, from the collarbone to the breastbone to the ribs.
During placement, the surgeon lifts the lower part of the pectoralis major muscle to create a pocket below it. They then place the implant in the pocket, such that the upper inner part of the implant lies beneath the pectoralis muscle and the lower portion extends up to beneath the breast gland.
Studies show that about 75% of breast augmentations done are submuscular. This is because it reduces instances of scar tissue contracture and enables easier mammography after surgery. This placement offers the best results for patients with thin bodies, sagging breasts, or those looking to enhance their breasts dramatically. This is the best reconstructive procedure for women who have undergone a mastectomy. Initially, the implants may sit high on the chest but slowly descend to a more natural position as the swelling reduces.
More natural appearance; Submuscular placement offers the best implant concealment. This is because the skin and the breast tissue cover the implant. The rippling and edges are less visible. You do not have to worry about getting the unflattering “bolted on” look that is common with large implants.
Lower risk of capsular contracture: In the post-surgery healing stage, the body develops capsule-like scar tissue around the implant. This is the body’s natural reaction to a foreign object. This process is helpful with implants as it prevents slippage by putting them in place. Sometimes, the capsule may become abnormally hard and contract around the implants. This leads to aesthetic problems and, in some cases, pain in the breast. Placing your implant under the chest muscle significantly reduces the risk of capsular contracture.
Preserved blood flow to the nipple; you can undergo a breast lift procedure if you’d like.
Reduced inferior malposition
Less interference with imaging during mammograms; In this placement, the implant is further away from the breast gland. Therefore, it is less likely to obstruct a mammogram.
Cons
More recovery time; With this procedure, you may experience more discomfort over a more extended period. As the placement involves incisions to the muscle, patients may experince temporary loss of strength in the chest muscle. The swelling also takes longer to reduce.
Complicated revision surgeries
Animation deformity; In some rare but possible situations, the patient may flex the pectoral muscle, causing the implant to move upward towards the armpit. This happens mostly during exercise and increases the risk of rupture.
Request a Quote
A consult with your plastic surgeon will put your mind at ease about which procedure is best for you. You can request a quote from Dr. Tarek Bayazid for the best transformation today. He uses a patient-focused approach, so your needs come first. Through his dedication to being at the forefront of cosmetic procedures, he will create a plan for you and deliver the highest quality.
Dr. Tarek Bayazid is a member of the American Society of Plastic Surgeons (ASPS), the International Society of Aesthetic Plastic Surgery “ISAPS”, and the Emirates Plastic Surgery Society (EPSS). He is proudly a member of the most prestigious societies worldwide such as the Melbourne Advanced Facial Anatomy Course – MAFAC from Australia by the eminent Dr.Mendelson.
Dr. Tarek Bayazid is a member of the American Society of Plastic Surgeons (ASPS), the International Society of Aesthetic Plastic Surgery “ISAPS”, and the Emirates Plastic Surgery Society (EPSS). He is proudly a member of the most prestigious societies worldwide such as the Melbourne Advanced Facial Anatomy Course – MAFAC from Australia by the eminent Dr.Mendelson.
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