Breast Implant Placement

Submuscular Placement, Subglandular Placement, Dual Plane Placement – Which Is Best?

As you navigate the important decision around breast implant placement, understanding your options becomes a cornerstone in this significant journey. This fundamental step involves acquainting yourself with different approaches such as ‘over the muscle,’ ‘under the muscle,’ and ‘dual plane’ placements. Each of these options carries its own set of advantages and considerations. Being knowledgeable about these allows you to have fruitful discussions with your plastic surgeon, where you can ask informed questions and understand the surgeon’s recommendations more clearly.

As you explore the details of breast augmentation, having a seasoned professional to guide you can be a significant advantage. Dr Carmen Munteanu MD. FRACS (Plas) regularly performs breast augmentation procedures using different types of approaches.

Take our Plastic Surgery Quiz to find out if you’d be a good candidate and if you are ready for cosmetic surgery.

Why Breast Implant Placement Matters

Understanding the different options for breast implant placement is essential because it can significantly affect the surgery’s results, including the look and feel of the breasts post-surgery. The right placement can:

• Align with your anatomical features: Your natural anatomy can dictate the best option for you. Some individuals may have more natural breast tissue, which can influence the preferred placement
• Meet your aesthetic goals: Different placements can offer various aesthetic results. Knowing your goals can help in selecting the right method
• Facilitate a smooth recovery: The placement can influence the recovery period. Some placements might offer quicker recovery times compared to others
• Impact future health screenings: Different placements can potentially impact the ability to conduct mammograms accurately

The Anatomy of the Breast Area

To understand the various options of implant placements, it is vital to have a grasp of the breast’s anatomy. The breast area is composed of several components:

• Skin: The outermost layer that covers the breast
• Glandular tissue: This tissue is responsible for milk production
• Fat: This layer surrounds the glandular tissue, giving the breast its size and shape
• Muscles: The pectoral muscles are found beneath the glandular tissue and fat. They play a key role in determining the implant placement
• Rib cage: The rib cage provides a base for the muscles and breast tissue

Over the Muscle Placement (Subglandular)

When pondering the options for breast augmentation, many find themselves considering the popular ‘over the muscle’ placement technique.

The ‘over the muscle’ placement involves positioning the breast implant directly behind the breast tissue but in front of the pectoral muscle. This is also known as subglandular or prepectoral placement. This approach is fairly straightforward and can be an option worth considering depending on various factors including your individual anatomy and desired results. Here we detail the aspects to understand about this type of placement:

• Surgery details: The procedure is generally simpler and involves less surgery time compared to under the muscle placements
• Anatomical considerations: Suitable for individuals with a good amount of natural breast tissue
• Implant type: Can be performed with various implant types, including silicone and saline implants

Subglandular Placement Benefits

Choosing ‘over the muscle’ placement can offer several advantages. These include:

• Natural look and feel: For individuals with a substantial amount of breast tissue, this method can offer a very natural look and feel
• Less post-operative pain: As the muscle is not being disturbed, there is generally less pain involved post-surgery
• Quick recovery: The recovery process tends to be quicker with this method, allowing you to return to your normal activities sooner
• No muscle distortion: Since the implant is placed over the muscle, there is no risk of muscle distortion, which can sometimes occur with under the muscle placements

Potential Downsides

While there are several benefits to ‘over the muscle’ placement, there are also some downsides to be aware of, including:

• Visibility of implants: In individuals with lesser breast tissue, the implant might be more visible or palpable
• Higher chance of capsular contracture: This method has shown a higher rate of capsular contracture, a condition where the scar tissue around the implant hardens
• Possible interference with mammograms: This placement might sometimes make mammograms more challenging, as the implant can obscure the view of the breast tissue

Download Dr Carmen’s Guide to Breast Augmentation with Implants Surgery

Under the Muscle Placement (Submuscular)

This method, renowned for offering a natural contour and a lower risk of certain complications, holds a significant place in the discussion around breast enhancement surgeries.

The ‘under the muscle’ placement, also known as submuscular placement, involves situating the implant beneath the pectoral muscle. This section unpacks the crucial details about this type of placement:

• Surgery details: This procedure often involves a more complex surgery compared to the over the muscle placement, with Dr Carmen working to position the implant underneath the pectoral muscle
• Anatomical considerations: It can be a preferred option for individuals with less natural breast tissue, as the muscle offers additional coverage for the implant
• Implant type: Similar to the over the muscle placement, it can be carried out using various implant types, including both silicone and saline implants

Benefits of Submuscular Placement

This method of breast implant placement offers a range of benefits, including:

• Natural contour: Many find that this option provides a more natural contour and shape, enhancing the overall appearance
• Lower risk of capsular contracture: Research has shown a potentially lower risk of capsular contracture compared to over the muscle placement
• Less interference with mammograms: The under the muscle placement can potentially offer less interference during mammograms, allowing for more accurate screenings
• Reduced visibility and palpability of the implant: By being placed under the muscle, the implant is less likely to be felt or seen, offering a more natural feel and appearance

Considerations to Keep in Mind

While the under the muscle placement offers numerous benefits, there are also several considerations to be aware of:

• More post-operative pain: Due to the muscle being manipulated during the surgery, you might experience more pain in the post-operative period compared to over the muscle placement
• Longer recovery period: The healing process can potentially take longer, requiring a more extended period of rest and recovery
• Potential for muscle distortion: With this method, there is a chance of muscle distortion, which can alter the breasts’ appearance, especially during physical activities involving the chest muscles

Dual Plane Placement

Breast augmentation offers a variety of options to ensure the results align with your expectations. A notable option is the dual plane placement, which combines aspects of both ‘over the muscle’ and ‘under the muscle’ placements to offer a balanced approach.

The dual plane method is essentially a hybrid approach, utilising the benefits of both over and under the muscle placements to achieve a more natural and aesthetically pleasing outcome. Here, we detail what you need to know about dual plane placement:

• Surgery details: The procedure involves placing the upper part of the implant under the pectoral muscle, while the lower part sits behind the breast tissue, hence taking a ‘dual’ approach
• Anatomical considerations: This method takes into consideration the individual’s natural anatomy to a great extent, helping in achieving a result that is harmonious with the individual’s body structure
• Implant type: It offers flexibility in terms of the type of implant used, accommodating both silicone and saline implants effectively

The Advantages of a Dual Plane Approach

Opting for a dual plane approach can come with several advantages, such as:

• Natural appearance: By harmoniously combining the benefits of both placement methods, a more natural appearance can be achieved
• Adaptable: This method allows for a tailored approach, taking into consideration the varying anatomical structures and individual preferences
• Reduced complications: The dual plane method can potentially reduce the likelihood of complications such as capsular contracture
• Aesthetic corrections: This approach can effectively correct existing issues such as breast droopiness

Potential drawbacks

Despite its benefits, it is essential to be aware of the potential downsides of the dual plane method, which include:

• Complex procedure: Given that it combines two methods, the surgery is more complex and may require a skilled plastic surgeon with experience in dual plane approach
• Longer recovery period: The recovery time might be longer compared to the singular approaches, given the complex nature of the procedure
• Potential for uneven results: There’s a risk of uneven results if not performed by an experienced plastic surgeon, necessitating a potential corrective surgery in the future

How to Choose the Right Breast Implant Placement for You

Choosing the right breast implant placement is a critical step in ensuring that you achieve the desired outcome from your breast augmentation surgery. It is essential to work closely with your surgeon to make an informed decision based on your individual anatomy, lifestyle, and aesthetic goals.

Step 1: Consider Your Anatomy

• Body Type: Your body type can influence the best placement option for you. Discuss with your surgeon how your natural anatomy might affect the outcome
• Breast Tissue: The amount of natural breast tissue you have can impact the visibility and feel of the implants

Step 2: Lifestyle Considerations

• Physical Activity: If you are highly active, especially in upper body workouts, subglandular placement might be more suitable to avoid implant movement and distortion
• Future Plans: Consider your future plans, including potential pregnancies, as they can affect the appearance of your breasts post-surgery

Step 3: Aesthetic Goals

• Natural Look: If a natural look is your priority, discussing the shape and profile of the implant with your plastic surgeon is essential
• Size: The size of the implant you choose can also affect the best placement option

Step 4: Consult with a Reputable Surgeon

In Australia, it is essential to consult with a surgeon who is a fellow of the Royal Australasian College of Surgeons (FRACS) and a member of the Australian Society of Plastic Surgeons (ASPS) to ensure they have the necessary training and experience.

Step 5: Personalised Approach

Every individual is different, and what works for one person may not work for another. It is essential to approach this decision with a personalised mindset, considering your unique circumstances and desires.

FAQs about Breast Implant Placement

Can I breastfeed after getting breast implants?

• Yes, many women can breastfeed after getting breast implants. However, it depends on various factors including the type of surgery, the placement of the implant, and individual circumstances. It is essential to discuss your plans for future pregnancies and breastfeeding with your surgeon before the procedure to ensure the best approach is taken to preserve breastfeeding functionality.

Will I lose sensation in my breasts after the surgery?

• There is a risk of altered sensation or numbness in the breasts following surgery, which can be temporary or permanent. The risk can vary depending on the surgical technique used and individual factors. It is important to discuss this potential risk with your surgeon during the consultation process.

How will the implants affect mammograms and breast screenings?

• Breast implants can potentially interfere with mammogram images and make it more challenging to detect abnormalities in the breast tissue. It is crucial to inform your mammogram technician about your implants so they can use special techniques to get the best possible images. Additionally, considering implant placement under the muscle might allow for more accurate mammogram readings compared to over the muscle placement.

Further Reading about Breast Augmentation

• Read Dr Carmen’s Breast Augmentation Melbourne

• Read Dr Carmen’s Breast Implant Types
• Read Dr Carmen’s Blog about History of Breast Implants and Origins of Breast Enlargement Surgery
• Read Dr Carmen’s Blog about Breast Augmentation FAQs – Questions about Breast Enhancement Surgery
• Read Dr Carmen’s Blog about Does Breast Enlargement by Fat Transfer To Breast Last?
• Read Dr Carmen’s Blog about How Big Is a C Cup? – Useful Advice for Breast Implant Surgery

Medical References about Breast Implant Placements

• Placement of Breast Implants – Mayo Clinic
• Where Will Your Breast Implants Be Placed? – American Society of Plastic Surgeons
• Breast Implants – Cleveland Clinic
• Dual Plane versus Subpectoral Breast Augmentation – NCBI
• Breast Augmentation – American Society of Plastic Surgeons