Breast Augmentation: Above or Below the Muscle?

The best New York plastic surgeons know that achieving a patient’s ideal breast augmentation results requires an individualized approach. Surgeons have a wide variety of options to choose from when it comes to surgical techniques, implant characteristics, and more. Your surgeon will talk to you about these options during your consultation. One key decision that the two of you will need to make is breast implant placement relative to the chest muscle.

Above the Muscle (Subglandular)

The pectoralis major muscle in the chest is located below the glandular breast tissue. When a breast implant is placed in the space above the pectoral muscle and below the glandular breast tissue, this is called subglandular placement.

Subglandular placement offers several benefits. First, it’s less invasive than placing an implant below the muscle. As a result, the procedure can take less time to complete. Additionally, a less-invasive procedure typically means a shorter and more comfortable recovery process.

Subglandular placement can reduce minor sagging and enhance breast shape. Additionally, this is an excellent placement option for patients who perform chest exercises often. No deformity occurs, meaning there is no unnatural-looking breast implant movement when patients contract their pectoral muscles.

Placing a breast implant above the muscle is best for patients with a fair amount of breast tissue, as this tissue is required for proper implant coverage. For these patients, it can improve the appearance of the cleavage and create a very natural look, including during movement.

When patients do not have enough breast tissue for proper coverage, this can result in visible rippling of the breast skin (caused by the edges of the implant). For these patients, the breasts may also look rounder in a way that looks less natural.

One of the major downsides of subglandular breast implant placement is that it can make it harder for doctors to interpret mammograms. It also comes with a higher risk of developing a condition called capsular contracture. With capsular contracture, the scar-tissue capsule that naturally forms around the implant becomes tighter, causing stiffness and pain.

Below the Muscle (Submuscular)

When a breast implant is placed below the pectoralis major muscle, this is known as submuscular implant placement. This is generally the more popular option, especially for leaner women.

Submuscular placement uses the chest muscle to cover the implant. Because of this, patients with smaller breasts and less natural tissue find it to be a better option. For these patients, results look and feel more natural.

Improved implant coverage reduces the likelihood of implant rippling in the breast skin. Capsular contracture risk is also decreased. Additionally, the improved implant coverage prevents any interference with mammogram results.

Placing an implant under the muscle tissue pushes the tissue forward, creating another benefit: enhanced upper-pole volume for the breast.

One downside of this placement option is a longer and more painful recovery period. There is also an increased risk of chest deformity when the chest muscles contract.

What Is Dual-Plane Breast Augmentation?

Dr. Lao has the experience and skill required to perform a specialized breast augmentation technique known as dual-plane breast augmentation.

This technique allows Dr. Lao to place the breast implant so that its lower section is subglandular and its upper section is submuscular. This process involves releasing the muscle’s inferior attachments to increase the size of the tissue pocket where the implant is placed.

Dual-plane breast augmentation is considered to be superior to the other placement options in several ways:

• The implant sits in a very natural position, ensuring very natural-looking results, even when the patient is moving.
• It gives the breast a gentle slope in the upper pole and a rounded lower pole, creating an anatomical appearance (especially for thinner patients).
• It creates a subtle internal lift, increasing perkiness.
• It offers a reduced risk of capsular contracture.
• There is a lower risk of damaging nerves and milk ducts, helping to avoid issues with breastfeeding.

Which Option Is Best for Me?

The best way for New York, NY, patients to find out which placement option is right for them is by meeting with double-board-certified plastic surgeon Dr. William Lao. During a personalized breast augmentation consultation, Dr. Lao will listen to your needs and goals. He will then discuss your implant placement options in greater detail. Contact us today to arrange your appointment.