Where will your breast implants be placed?

If you are considering breast augmentation there are many questions you will want to have answered by the plastic surgeon before making your final decision.

Among a host of other important questions that you should ask during your breast augmentation consultation is "where the breast implants will be placed?"

Many patients are not aware that there is an option when it comes to the placement of the breast implants. Implants may be placed either over the muscle or under the muscle, and there are several factors which help determine the optimal implant placement for each individual patient, including:

• Your body type
• Your current health
• The actual size (cc's) of the implants
• Saline vs silicone implants
• Your individual goals and desires

Board-certified and experienced plastic surgeons who have performed a high volume of breast augmentation surgeries will be able to direct the best position to determine optimal implant placement, and it is extremely important for breast augmentation patients to understand the pros and cons for the two different placement options.

Subglandular placement

Also known or referred to as "over-the-muscle" placement, the subglandular placement technique is where the implant is positioned between the chest muscle and the existing breast tissue areas. The over the muscle positioning is done so the implant lies below the glands of the breast, thus providing the ability for the patient to breast-feed in the future.

PROS: Patients tend to have less movement of the implants during physical activity, as well as less discomfort immediately following the surgery.

CONS: The appearance can me more artificial. In addition, during mammograms the readings may be less accurate. Also, patients may experience a higher rate of capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant.

Submuscular placement

The other option is known as submuscular, or under-the-muscle placement of the breast implant. This technique includes placement of the implant partially under the pectoralis major chest muscle.

PROS: Patients experience more accurate mammograms. In addition, the submuscular placement tends to produce a more natural appearance, and a reduced rate of capsular contracture.

CONS: Some patients experience slightly more discomfort after surgery, with a longer postsurgical recovery.

The role of the chest muscle

The muscles in the chest play an important role in breast augmentation procedures with regards to optimal placement of the implants. Each individual patient will vary in the amount of muscle they have and this could be a factor in determining whether subglandular or submuscular placement is best.

The anatomy of each patient must be factored in. For example, women who have very large or strong chest muscles will be best suited for over-the-muscle positioning of the implants. One reason for this is with larger chest muscles there will be a tendency for distortion of the breasts as the chest muscles move and are flexed. In these cases, subglandular placement is advised.

How much breast tissue is present

In addition to the muscle density and mass, the amount of tissue in the breast area before surgery will also have an impact on where the placement should be for optimal postsurgical results. When there is a significant amount of breast tissue, there will be adequate soft tissue coverage making the pectoralis muscle superfluous in this regard.

As you move through the process of selecting your breast surgeon, and during your consultation about the procedure, you will want to discuss the placement of the breast implants, going over which option – over the muscle or under – will be best for you.