Submuscular Placement

There are two main location choices to consider for breast implants. There's the subglandular breast implant located under the mammary gland but above the chest muscle, and there's the submuscular implant, also known as under-the-muscle breast implants. Each type has their own individual benefits and drawbacks, and it's important to understand the differences to get the kind of results you want.

Under-the-Muscle Implants Placement

Submuscular, also known as subpectoral, breast augmentation inserts the implant underneath the pectoral muscle in the chest. The chest muscle can accommodate this because it's connected to the chest wall along the muscle's outer perimeter, creating a natural pocket where the implant is inserted.

When this method is chosen, the muscle normally covers around two-thirds of the implant. A partial submuscular breast augmentation is when the implant doesn't get wholly covered. Total, or complete submuscular breast augmentation, is when other chest wall muscles cover the last part of the implant. The complete method utilizes inframammary, areola, or transaxillary incisions.

Benefits of Submuscular Implants

Under-the-muscle breast implants tend to create a better and more attractive look for naturally small-breasted women. Since the implant is concealed underneath the pectoral muscle, flaws in the implant like ripples or the edges of the implant are hidden. Submuscular placement, along with silicone implants, tend to produce a more natural appearance and feel to the breasts, especially for thinner women with smaller breasts.

Submuscular implants don't obfuscate mammography exams, like subglandular implants sometimes do. Because the implant is behind the muscle, the breast tissue can be clearly checked for cancerous tumors by the mammogram. With the implant placed ontop of the muscle but underneath the implant, the results of the mammogram can sometimes be less clearly defined.

One risk that affects subglandular breast implants less than under-the-muscle breast implants is capsular contracture. This tightening of the scar tissue that happens with some patients can painfully squeeze the implant, creating a distorted look and hard feel in the breasts. Implants under the chest muscle are not as prone to this condition as their above-the-muscle counterparts.

Lastly, "bottoming out" has less of a chance of occurring with implants placed under the muscle. This condition occurs when the implants have been placed too low along the chest wall, making the nipples appear to be too high up on the breast.

Visit the DocShop gallery to view breast augmentation before and after photos.

Photo credit: James P. Wire, MD

Drawbacks of Under-the-Muscle Implants

The main issue that keeps patients from getting this procedure is that the surgery and recovery, when compared to subglandular implants, is longer and more painful. This is because the harder, less flexible muscle tissue is being manipulated instead of just the mammary gland and fatty tissue found within the breast itself. Further procedures with under-the-muscle breast implants are also more difficult when compared to future procedures with subglandular implants.

This type of placement also makes it harder to create cleavage with women whose breasts are already widely spaced, particularly with textured breast implants.

Women who are very active and athletic, especially weight lifters and body builders, may prefer subglandular implants instead. This is because the submuscular implants don't flex along with the pectoral muscles, creating an irregular look to the breasts while flexing. Also, extremely strenuous exercises to the chest muscles may displace the breast implant.

Finally, under-the-muscle breast implants tend to sit higher on the chest than usual, at least until the muscle relaxes.

Discuss Under-the-Muscle Breast Implants with a Qualified Surgeon

When it comes to knowing more about a surgery, especially something as impactful and potentially beneficial as under-the-muscle breast implants, potential patients should always consult with a qualified and experienced surgeon first. If you are looking for a surgeon in your area, DocShop's physician directory can help you find a surgeon that's right for you.