Submuscular vs. Subglandular Placement of Breast Implants
Submuscular vs. Subglandular Placement of Breast Implants
Most surgeons have an inherent preference for the pocket the implant is placed in. Both the subglandular and submuscular pockets are satisfactory in individual patients but in some cases one approach will be better than the other.
I typically prefer the submuscular approach for breasts with little to no sagging. In cases of breast sagging of a modest nature a subglandular approach can be considered to avoid breast lifting, with its associated incisions/scars. In short, both approaches can be used in certain circumstances. Most breast surgeons will be able to guide your choice based upon your anatomy and your preferences. (Jon F. Harrell, DO, Miami Plastic Surgeon)
Best implant position when using saline
Breast implant locations scar under
Will vary according to your own needs and anatomy. The preceding answers do illustrate some of the issues we have with saline implants but if you have adequate breast tissue, rippling will be a minimal issue. Your surgeon should help you decide on what is best for you after considering your concerns. As for which incision is best, that is also your choice but a recent study implicated axillary incisions as being associated with the highest rate of contracture. And you should know your surgeon’s revision policy as there are some approaches that require more revisions and potentially more cost to you. (Curtis Wong, MD, Redding Plastic Surgeon)
How breast implants are placed during breast augmentation
Without any droop(ptosis) to the breasts, saline implants are best put behind the muscle. The lack of stability of a saline filler makes the implant more visible and palpable. Without photos, it is best to visit a board certified plastic surgeon who can go over the reasons for implant placement. (Thomas P. McHugh, MD, Houston Plastic Surgeon)
Saline implants are best positioned under the muscle if possible to camouflage potential contour abnormalities.
Whereas silicone gel implants have few problems with contour irregularities above or below the muscle, saline implants have decidedly fewer of these aesthetic problems when placed below the muscle.
implants place gallery
I preferentially put saline implants under the muscle all other things being equal. (Vincent N. Zubowicz, MD, Atlanta Plastic Surgeon)
Under the muscle
I agree with the others here: Under the muscle is the way to go. Unders: hurt more take longer to heal ( drop ) but in the long run, look more natural, have fewer problems with rippling and capsular contracture. The majority of plastic surgeons still do under the muscle. In south america and most of europe ( and now parts of south florida and california), these are over the muscle but I believe that is a cost issue:
Breast implants scar
Over the muscles are less expensive to do and may be done under local or light anesthesia in a doctor’s office. However, if you look at some examples on the internet of overs at 5 and 10 years out, you will find many have issues with rippling, capsular contracture, and a very fake 1/2 a grapefruit stuck to your chest look. (Bennett Yang, MD, Rockville Plastic Surgeon)
Best Option for Saline Implants
In most situations, saline implants are always placed under the muscle. In fact, this is also true for gel implants by most US surgeons. There is less chance for scar contracture around the implant and the results are more natural. Saline implants do not perform well in front of the muscle due to wrinkling or ripples.
breast implants recovery
My preferred approach is a saline implant placed under the muscle via an axillary incision (armpit) . I also think the implants should be filled to the upper amount recommended by the manufacturer in order to minimize wrinkling.
With this approach, my patients have been very happy and very few (less than 1%) have experienced any wrinkling or ripples. (Steven L. Ringler, MD, FACS, Grand Rapids Plastic Surgeon)
Since you are choosing to have saline implants I would advise you to have submuscular placement of the implants (Norman Bakshandeh, MD, FACS, New York Plastic Surgeon)
