Choosing Implant Placement

Seriously, it’s like the decisions are never-ending!  You have to decide between silicone and saline, round or teardrop, textured or smooth.  Then you have to decide where the incision should be.

Now you have to decide whether the implant should be placed under or over the pectoral muscles.  Here’s some help.

Subglandular Placement

Subglandular implants are placed under the mammary gland and over the pectoral (chest) muscle.  All four types of incisions and all types of implants can be used for subglandular placement.

Advantages:

    • Cleavage is more pronounced.
    • Recovery time is shorter and easier because only skin and fat are cut, not muscle.
    • Subglandular placement is an overall simpler method.  It is easier for the surgeon to place the implant and to access it if further surgery is needed down the road.
    • For women with strong chest muscles, subglandular placement is preferable because strong pectorals can shift the implant when they are flexed.

Disadvantages:

    • This placement has the highest risk of capsular contracture.
    • Subglandular placement can hinder mammograms.
    • Implants placed over the chest muscle have a more round and somewhat fake look.  Of course, that’s the look some women are going for so, they may not find that a disadvantage!
    • Any issues with rippling are more apparent without the extra covering of muscle.

Submuscular Placement

Submuscular placement means the implant is put under the chest muscle.  All types of implants can be placed this way, and incision placement can include areola (nipple), inframammary (breast crease) and transaxillary (armpit).

Advantages:

    • Placing the implants under the chest muscle tend to make for a more natural look as the extra covering of muscle does a better job of hiding the edges of the implant and any rippling that may occur.  This is especially the case for very small-breasted women who don’t have a lot of breast tissue to start with.
    • Lower risk of capsular contracture.
    • Lower risk of interfering with a mammogram.
    • Less possibility of bottoming out of implants, as the muscles help keep them in place.

Disadvantages:

    • Cleavage is less pronounced.
    • Recovery time is longer and more painful because the muscles have to be manipulated.
    • This will not work well for athletic women with strong chest muscles as the implants will shift when muscles are flexed.

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