Submuscular Breast Augmentation

Just as breast implant shapes, breast implant textures, and breast implant fillers (saline breast implants vs. silicone breast implants) vary among women, so too does the location of breast implants. Depending on your circumstances, submuscular breast augmentation may be the choice for you.

Submuscular Breast Implant Placement

Submuscular, or subpectoral, breast augmentation involves placing a breast implant behind the pectoral muscle. Since the muscle is only attached to the chest wall around its edge, there is a space underneath it where the breast implant can be placed.

In most cases, the pectoral muscle will cover approximately two-thirds of a breast implant. When the breast implant is not completely covered by muscle, it is referred to as a partial submuscular breast augmentation. Complete, or total, submuscular breast augmentation is achieved by using other muscles on the chest wall to cover the remaining third of the breast implant.

Complete submuscular placement can be achieved via transaxillary breast implant incisions, areola breast implant incisions, or inframammary breast implant incisions.

Advantages of Submuscular Placement

Unlike subglandular breast augmentation, which places the breast implant in front of the muscle, after complete submuscular breast augmentation the breast implant is fully covered by the breast tissue and muscle. This helps to conceal the edges and ripples of the breast implant, creating a more natural appearance and feel of the breasts after surgery. Submuscular breast implant placement seems to produce more favorable results in women with smaller breasts than subglandular breast augmentation.

Placing an implant under the pectoral muscle during breast augmentation may reduce the fear that breast enhancement surgery will hinder breast cancer detection. Although there is a possibility that any breast implant may obscure some breast tissue during a mammogram, clinical studies have shown that submuscular breast implant placement does not interfere with mammography exams.

Submuscular breast augmentation has a lower risk of capsular contracture, the tightening of scar tissue that squeezes a breast implant. Capsular contracture may distort the appearance of the breast and can create an unnatural firmness, which may become painful.

Submuscular breast implant placement lowers the possibility of "bottoming out," which is a complication of breast augmentation in which a breast implant ends up too low on the chest wall, causing the nipples to be positioned too high on the breasts.

Disadvantages of Submuscular Placement

Because the pectoral muscles have to be manipulated to place the breast implant, submuscular breast augmentation tends to involve a longer surgery, increased post-operative discomfort, and an extended recovery time compared to subglandular breast implant placement. The involvement of chest muscles in submuscular breast implant placement also makes further procedures more difficult.

Submuscular placement of a breast implant may also hinder the creation of cleavage with breasts that are widely spaced, especially with the use of textured breast implants.

Athletic women, especially those who lift weights, tend to have a worse cosmetic result with submuscular breast augmentation since the breast implant does not flex with the pectoral muscle. This may create a distorted appearance. Also, exercises that use the chest muscle may cause the breast implant to become displaced.

A temporary disadvantage of submuscular breast augmentation is the fact that breasts will sit a little higher than usual on the chest until the pectoral muscle relaxes.

Find a Cosmetic Surgeon near You through DocShop

If you are considering breast implant surgery, you should further discuss the pros and cons of submuscular breast augmentation with your plastic surgeon. If you are not already working with one or if you would like to interview other surgeons, you can find qualified local cosmetic surgeons using DocShop's physician directory.