The location selected for placement of breast implants is determined by several factors. They can be placed either partially under the pectoralis muscle (submuscular) or over the pectoralis muscle on the chest and under the breast tissue (subglandular). The term “dual-plane” refers to the placement of the implant underneath the muscle in its upper pole, and underneath the breast tissue in its lower pole. The goal is always to provide optimal long-term coverage of the implants and to avoid creating deformities which cannot be corrected, such as visible implant edges and rippling.
Subglandular placement of breast implants under the breast tissue is generally not advised for women with thin tissues, as the implant edges may become more visible. In addition, the implant itself may show rippling, and the edges can sometimes be felt. Mammograms are more difficult to perform with implant placement beneath the breasts. There is also a higher risk of capsular contracture, or scar tissue formation, around the implant following subglandular placement.
Submuscular or dual-plane placement of breast implants is recommended for women with thin breast tissue, as the edges of the implant will be well-concealed. The edges of the implant will also be less likely to be felt. Mammograms are easier to perform as compared to subglandular placement, as the breast tissue can be more easily compressed when the implant is placed behind the muscle. There is a significantly lower risk of capsular contracture, or scar tissue around the implant, when the implant sits in a location behind the muscle. Although the surgery is associated with slightly more pain when the lower edges of the muscle has been opened, most patients are off pain medication within two days following their procedure. Dr. Naidu recommends a dual-plane location for placement of breast implants in almost all cases.
Breast Implant Placement: Subglandular VS Submuscular
Breast implants can be placed behind the pectoral major muscle or forward and under breast tissue. The goal is to cover the implants and avoid deformities that can not be corrected, including visible wrinkles and ripple. For most breast augmentations Dr. Naidu prefers placing the implants under the muscle. Clinical studies have shown a decrease in the incidence of capsular contracture (scar tight around an implant) following implantation below the pectoralis muscle as opposed to above.
- Under the breast tissue
- Not recommended for lightweight fabrics
- Implants are more visible and palpable
- High risk of capsular contracture
- Mammography is more difficult
- Under the muscle
- Suitable for lightweight fabrics
- Implants are less visible and palpable
- Low risk of capsular contracture
- Mammogram is easier
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