Breast augmentation is the number one cosmetic procedure in the United States. Though there were over 300,000 breast augmentations performed nationwide just last year, no 2 procedures are exactly alike. When women seek breast implants at my Los Angeles plastic surgery center, I customize the procedure to fit the patient’s specific needs. Implant size, shape, material, and profile, along with incision placement, are just a few of the choices you must make before your procedure. Additionally, implant placement is something you will need to discuss with your surgeon. In this post, we will discuss the benefits of each placement option.
About the Procedure
During your augmentation procedure, I will first create a pocket in each breast that will hold the implant. This pocket can be in one of 2 places: either in front of the pectoral muscle or behind the muscle. The decision about where to place the implant is influenced by physical factors, implant type, and lifestyle.
In Front of the Muscle
In the early days of breast augmentation, all implants were placed in front of the muscle, called a “sub-fascial” placement. However, as surgical techniques evolved, doctors began placing implants behind the muscle for some select patients.
For women with a moderate amount of existing breast tissue, I sometimes place the implant in front of the chest muscle. This placement usually results in a shorter recovery and can reduce the risk of changes in the shape of the breast post-surgery. However, for women with little existing breast tissue, visual rippling or wrinkling is more likely with a sub-fascial placement. This happens because the tissue does not adequately cover the implant, causing results to look unnatural.
Behind the Muscle
Placing the implant behind the muscle is my preferred choice to achieve a more natural look. Many board-certified surgeons also contend that sub-pectoral muscle implants are better supported and result in less sagging. For women with very little natural breast tissue, I usually recommend sub-muscular implant placement. The more “padding” you have in front of the implant, the less likely you will notice rippling.
Although this placement requires slightly longer recuperation time, it can help reduce the risk of capsular contracture. Capsular contracture is a complication that occurs when scar tissue forms tightly around the implant, potentially leading to deformation and pain.
Sub-muscular placement is also a common choice for women who are choosing anatomically shaped implants because the muscle prevents the implants from rotating in the pockets. These teardrop-shaped implants must stay in the correct orientation to achieve optimal results and a natural look.
Additionally, implants that are placed below the muscle allow for better visibility during mammograms. This can be especially important for women who have a family history of breast cancer.
Although I prefer to place implants under the pectoralis major muscle, there can be circumstances or patient preferences that warrant alternative implant placement.
The best way to know what is right for you is to request a consultation online or call our office at (310) 300-1779.