Under the Muscle or Over the Muscle – What’s the Difference?

January 29, 2014

Much is written about the issue of breast implant placement, namely submuscular (under the muscle) or subglandular (above the muscle and below the breast tissue) placement. What is being talked about is where the pocket is created to put the implant into. During breast implant surgery, a pocket is created to house the newly inserted breast implant.

Prior to surgery, tissue layers are stuck together like a sticker to its backing and only during the breast augmentation surgery are the tissue layers separated so as to accomodate the implant. This pocket can be made either above the pectoralis (chest) muscle or below the pectoralis muscle. The advantages of placing the implants below the muscle are that the final result may have a slightly more natural look and the rate of certain complications such as capsular contracture and downward migration (“bottoming-out”) of the implant may be reduced. As such, Dr. Backstein suggests submuscular implants to most patients.

In certain cases, the pre-existing breast anatomy and position will indicate that subglandular (above the muscle) placement of the breast implants is advisable. In particular, a woman with a substantially sized breast that has become deflated and droopy or pendulous, usually as a result of pregnancy and breat-feeding, will usually benefit from placing the breast implants above the muscle since this allows the volume of the implant to better “perk-up” the loose, hanging breast tissue.

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