Over vs. Under the Muscle Breast Implants

Which implant placement is right for your particular needs is a choice that only you can make the final decision on. At the Broadway Center for Plastic Surgery located in the Denver area, Dr. David Broadway and his staff feel that each of their patients has not only a right, but an obligation to themselves to be sure they are well informed before electing to undergo any type of surgery.

Breast implant surgery is no different. A patient’s choice to receive breast implants should be well thought out and researched. An educated and informed patient is a happy and satisfied patient. This also makes the surgeon’s job easier knowing his patient is taking an active part in the planning and outcome of their breast implant surgery.

Implant placement methods
There are three methods used when placing breast implants. Which method used is based on where it is placed in relation to the muscles of the chest (pectoral muscles). Each has advantages and disadvantages.

Sub-glandular
Sub-glandular (over the muscle) involves placement behind the breast tissue, but the implant remains over the chest muscles. This is the easiest method to perform and involves the least amount of recovery time. There is also less pain and discomfort due to having only skin and fat with an incision.

Disadvantages of sub-glandular placement:

A future breast lift may be necessary.
Wrinkles or indents in the skin, called ripples, can be felt and seen more easily.
Risk of capsular contracture is highest with this type of placement.
Sub-glandular implants tend to be more rounded, rather than natural looking.

Sub-pectoral
Sub-pectoral (partial sub-muscular) involves placing two thirds of the implant behind the chest muscle, with the remaining third behind only breast tissue. With this placement, only the portion of the implant that remains above the muscle is at risk for visible ripples. Capsular contracture is a lower risk and there is more of a natural shape to the breast.

Disadvantages of sub-pectoral placement:

More discomfort and a lengthier recovery period
It takes longer for the implants to settle into position
There is more chance of the implant bottoming out (dropping below the breast tissue)
There is still a portion of the implant susceptible to rippling

Complete sub-muscular
Complete sub-muscular (under the muscle) places one third of the implant behind the fascia (tissue connecting the chest muscles), creating a built-in support bra for the implant. The remaining portion of the implant is not only beneath the breast tissue but also beneath the chest muscles. This method provides the least chance of capsular contracture and rippling. It is also the best method for obtaining accurate mammogram readings.

Disadvantages of complete sub-muscular placement:

It is the most difficult implant surgery to perform, so it is not offered by many surgeons
It has the most discomfort and recovery time involved
It takes longer for the implant to settle because the chest muscles need to relax
A future breast lift may be needed if sagging begins to occur

It is crucial to your surgical procedure and its outcome that you take the time to research all aspects of your potential surgery and discuss every aspect of it in detail with your surgeon during the consultation. Contact your patient advocate at the Broadway Center for Plastic Surgery in Denver, Colorado.

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Disclaimer: The information throughout this Denver Breast Augmentation website is not intended to be taken as plastic surgery advice. The information provided by Dr. Broadway, breast surgeon is intended to provide general information regarding breast enlargement, breast augmentation, breast enhancement, and breast lifts for residents of Boulder, and Denver, Colorado and to help you find a Colorado cosmetic surgeon. If you are interested in cosmetic surgery in Denver or Boulder, contact Dr. Broadway Today.