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Type of Breast Implant placement, which one is right for you ?

There are three different ways that implants can be placed in your body and they all have different advantages and disadvantages. Read on and while you do, give some thought to your end goals with regards to the appearance of your breast and maintenance down the road.

Implant Placement Over the Muscle:

If you’ve ever seen a woman with very obviously enhanced breasts, she most likely had this type of implant done. These implants are placed within the breast, behind the mammary gland, right along the chest wall. Advantages to this placement are ease of surgery (almost any surgeon can perform this procedure), avoidance of mastopexy in mild ptosis (though this can make the ptosis worse later), less discomfort post-operation as the only tissues being cut are fat and skin. There are some significant disadvantages as well including marked interference with mammograms (about 40% obstruction), the obvious visibility and feel of the implant edges (some women do not mind this and even prefer it), visible rippling of the skin over the implants, particularly with textured implants and a high rate of "bottoming out" (the downward migration of the implant). This implantation method is also associated with the highest risk of developing capsule protraction. 

Implant Placement Partially Under the Muscle:

Partial submuscular implants are placed under the muscle via either an inframammary incision or a peri-areaolar incision. With this placement, the implants are mostly behind the muscle wall, with only the bottom portion uncovered by muscle tissue. Advantages to this particular methodology include unobstructed mammography, a more natural look, much less visibility and feel of implant edges (except with textures implants) and a much lower risk of capsule contracture. Disadvantages may include more discomfort post-op and the technique is a bit more difficult, requiring a surgeon with experience in this technique. A significant disadvantage to this methodology is similar to that of the over the muscle technique, which is that the lower pole support fascia at the bottom of the breast is severed, making "bottoming out" more likely than it would be with an intra-muscular implant. Bottoming out is not as common with this method as it is with the over the muscle technique, however, and many women prefer the more natural look and feel.

Implant Placement Completely Under the Muscle:

Complete submuscular coverage of the implant is a favored technique by many surgeons; however it is a complicated, highly specialized procedure and not offered by all surgeons. Advantages to this placement include ease of placement, natural breast shape and no implant visibility. Very rarely is it possible to see any implant rippling under the surface of the skin.Capsule contracture risk is extremely low, as is mammography interference. The lack of cutting into the fascia tissue means that the support the implant receives is excellent and there is virtually no risk of "bottoming out". Of course, many women especially appreciate the lack of scarring anywhere on their breasts as well. The biggest two disadvantages to this procedure are that it is a highly specialized technique so not always readily available and that muscle-discomfort post-op is very likely. Also, immediately post op, the breast tissue tends to be extremely “perky” until the fascia has had a chance to stretch a bit.

Consult with your surgeon about these options and think carefully about which one is right for you. There are several things to consider, such as whether or not you want to have the highest chance of preserving breastfeeding possibilities in the future, your personal pain tolerance level, and what looks best for your body, as well as the potential size that you wish to increase your breasts to. These things will all affect the type of implant procedure that you and your surgeon choose. Learn how breast surgery can affect your breast sensitivity.

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