Above or below the muscle?
Should the Breast Implant be Placed Above or Below the Muscle? Sub Glandular or Sub Muscular
During your initial breast enhancement consultation in our Denver office, one of the first decisions you and Dr. Squires must make is where to place the breast implant. There are two choices: between the gland of the breast and the pectoral muscle (sub-pectoral), or below the pectoral muscle (sub-muscular). Each has its advantages and disadvantages and the needs of each breast enhancement patient must be considered on an individual basis.
Originally, in breast augmentation surgery, the breast implant was placed beneath the gland of the breast and above the muscle. This worked well for most patients, however a significant number of, perhaps as high as 50%, developed hardening of the layer of scar tissue around the implant (capsular contracture).
Experience has shown that placing the implant beneath the pectoral muscle significantly reduced the risk of hardening of the capsule around the implant. Dr. Squires has been a leader in introducing other technique refinements that have dramatically reduced the chance of capsular contracture.
The submuscular implant position does have some problems of its own. Occasionally there is some motion of the breast when the pectoral muscle contracts, for example when working out. While placing the implant under the muscle reduces the chance of wrinkling, it does not totally eliminate the possibility.
In the case of significant drooping of the breast (ptosis) an implant above the muscle may better fill out the breast tissue and give a better result, but in most cases it is better to do a lift than put implants above the muscle.
Many other factors need to be considered when deciding on the position of the implant these include: the size of the implant, the possibility of wrinkling of the implant and the patient’s choice of incision.
Ultimately the choice of implant position must be tailored to the patient’s needs. Each surgeon will have a different experience and develops a technique with which he or she gets their best results. There are no fixed rules or clear-cut answers when it comes to implant position. Most people will get the best result with smooth implants under the muscle. As always, your best decision is made in consultation with an experienced board certified plastic surgeon like Denver breast enhancement surgeon John Squires, M.D.
If you are interested in breast enlargement in the Denver, Colorado area, contact us or call 303-321-3210 to schedule a consultation.