Advantages of Placing Breast Implants Behind the Muscle
In breast augmentation surgery, implants are positioned in a “pocket” located either in front of the pectoralis major muscle (submammary) or in one behind it (submuscular/subpectoral). Though successful results can be achieved with both options, placing breast implants behind the pectoralis major muscle has the following advantages:
- Improved mammogram accuracy – When implants are placed behind the muscle, evaluation and interpretation of the mammograms are often easier and may be more accurate and definitive.
- Reduced risk of capsular contracture – The risk of developing firm scar tissue around the implant (capsular contracture) is lower when implants are placed in a submuscular pocket.
- More soft tissue coverage – With a greater amount of tissue covering the implants, the breasts will feel and look more natural. In addition there is a reduced risk of experiencing noticeable rippling that can be seen on the skin. When there is rippling, which is not rare with saline breast implants, the extent of it is far lower when they are situated behind versus in front of the muscle.
- A more natural appearance – The interface between the implant and chest wall is more gradual and smooth with subpectoral placement, allowing for a more natural appearance. This is in contrast to an often fake-looking, very round, bolted-on look for implants placed in front of the muscle.
- Better support – In the submammary position, the weight of implants tends to cause greater stretching and thinning of the overlying skin. This can lead to an increased amount of drooping over time, more breast contour irregularities and a greater likelihood to both feel and see rippling from the underlying breast implants. Compared to only skin supporting the implant, the pectoralis major muscle provides superior long-term support when the implant is positioned submuscularly.
For these reasons in particular, I strongly recommend placing implants behind the muscle for virtually all of my patients.
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