procedures Implant Placement July 20, 2011 Written By: BreastImplants.org Published On July 20, 2011 Once you’ve made the exciting decision to have breast implant surgery for augmentation or reconstruction, your decision-making has only begun! One of the other big considerations you have before your surgery is where the implant will be placed. There are three options: over, partially under, or fully under the pectoral muscle. While there are advantages and disadvantages to each option, be sure to ask your surgeon for his professional opinion about which will suit you and your personal needs. Please Read This: Inverted Nipple Repair Above the Muscle Subglandular implants are placed above the pectoral muscle, functioning as a barrier between breast tissue and the muscle on the wall of the chest. The resulting look can be rounder than natural breasts. Pros: Relatively easy for surgeons to place and access, which is useful for post-surgery access. Normally less pain following surgery because the muscle has not been cut or disturbed. Easier to insert larger implants. Easier to create cleavage. Cons: You Might Like This: Malpractice: How To Avoid It (And What To Do If Your Surgeon Has Done More Harm Than Good) Can obstruct mammograms by as much as 40%. Elevated risk of capsular contracture The edges of the implant may be visible or detectable through touch (especially if the woman selects implants with textured shells). Increased possibility of “bottoming out,” when the crease of the breast lowers and the nipple points upwards. May increase a woman’s difficulty with breastfeeding. Partially Below the Muscle With partial submuscular placement, the implant will be partially covered by the muscle at the top, and come into contact with breast tissue at the bottom. This placement is commonly done with the crease or nipple incisions. Pros: Does not usually interfere with mammograms. Implant edges are less visible. Final look appears more natural. Reduced risk of capsular contracture is reduced. Cons: More difficult to perform than subglandular implants Often more pain following surgery. Higher risk of bottoming out than the submuscular technique. Fully Below the Muscle The submuscular method, places the implant completely below the patient’s pectoral muscle; it does not come into contact with breast tissues. Unlike the partial submuscular technique, connecting muscle at the bottom is left intact, helping to support the breast and often preventing bottoming out. Full under-muscle placement is best accomplished through the transaxillary (armpit) incision. Pros: May increase breastfeeding chances. Greatly reduces likelihood of bottoming out and capsular contracture. Creates a natural look. Decreased possibility of interfering with mammography. Reduced visibility of implant. Cons: More challenging procedure. More pain and/or discomfort for the patient after surgery. Increased discomfort until the muscle bridge that supports the bottom (the “support fascia”) stretches to accommodate the new implant. Recommended Articles procedures Recovery procedures Triple Plane Surgery procedures Elective Mastectomy: Can Breast Cancer Be Prevented? procedures Study Finds That Choices In Reconstruction Depend On Patient And Hospital Characteristics procedures Nipple Tattoos: A Reconstruction Alternative Growing In Popularity Most Searched Questions What size is right for me? How much does breast augmentation cost? What should I ask my plastic surgeon? How do I find a plastic surgeon? Tags: procedures placement pre-surgery considerations submuscular subglandular Comments Learn More: Nipple Piercings Before And After Breast Augmentation Surgery The Sounds Your Implants Will Make Tattoos Do's And Don'ts Exercises And Massage After Breast Augmentation Sports With Breast Implants Is Your Bra Ruining Your Implants?