Your Guide to Breast Implant Placement: The Pros & Cons of Each Technique

If you’re considering breast augmentation to improve the size and shape of your breasts, you know that a lot of planning and forethought goes into the procedure. Many patients spend hours researching the different types of breast implants available, jotting down notes for their initial consultation and visualizing their results. However, an often overlooked detail can have a significant impact on the outcome of your breast augmentation: implant placement. Your breast implants can be placed under the chest muscle, over the chest muscle, or somewhere in between, depending on your unique anatomy, goals and preferences. 

At The Gillian Institute, our goal is to help patients learn more about the various options available for their breast augmentation, equipping them with the knowledge and confidence to make informed decisions about their procedure. Keep reading to learn more about breast implant placement, the pros and cons of each option and how this aspect of your procedure can influence your final results.

Breast Implant Placement Options

Breast implant placement plays a crucial role in achieving your desired outcome. There are various placement options to consider, but the two primary techniques are subglandular placement, where the implants are inserted directly behind the breast glands, and submuscular placement, which positions them beneath the chest muscle.

Additionally, there are variations like the subfascial placement, which involves inserting the implants between the fascia and the chest muscle, and dual plane breast augmentation, which combines aspects of both subglandular and submuscular techniques. Understanding these different breast implant placement options is essential in making informed decisions that align with your unique goals and anatomy.

Over the Muscle: Subglandular Placement

Subglandular placement refers to positioning the breast implants over the chest muscle and behind the breast glands. This placement option offers distinct benefits, such as a shorter recovery, less interference with muscle movement and natural-looking results for women with a sufficient amount of breast tissue to cover the implant. 

Pros of Subglandular Placement

Less Invasive Procedure

Subglandular placement is considered a less invasive technique than positioning the implant beneath the chest muscle. During surgery, the muscle is left undisturbed and there is less tissue manipulation overall, so the recovery tends to be shorter and more comfortable. Swelling is also less dramatic and subsides quicker with subglandular placement, revealing the final results of your breast augmentation sooner. 

Suitable for Active Patients

With subglandular placement, the breast implants are situated above the chest muscle, rather than underneath it. This means that the implants will not move or flatten out when the chest muscles are flexed during physical activity, distorting their appearance. Due to this, women who frequently engage in intense workouts or sports may prefer subglandular placement. 

Natural-Looking Results

Subglandular placement may be particularly beneficial for patients who have enough natural breast tissue to cover the implant. In such cases, the implants are less likely to be visible or beneath the skin, resulting in a natural appearance. The presence of sufficient breast tissue helps create a smooth transition between the natural breast tissue and the implants. 

Cons of Subglandular Placement

While subglandular placement has its advantages, there are some drawbacks to consider. Subglandular placement may result in more visible rippling, especially for individuals with thin skin or minimal breast tissue. Over the muscle placement can also increase the risk of certain complications and may slightly interfere with the interpretation of mammogram results.

Under the Muscle: Submuscular Placement

Submuscular placement, also known as subpectoral placement, involves detaching the fan-shaped chest muscle from the bottom along the ribs and inserting the breast implant underneath it. This technique offers its own set of advantages that make it appealing, such as less visible rippling, more implant coverage and a reduced risk of capsular contracture.

Pros of Submuscular Placement

Minimizes Rippling

Submuscular placement can help minimize the visibility of rippling or wrinkling that may occur on the surface of the breast implants. By positioning the implants beneath the chest muscle, the additional coverage helps conceal any irregularities or imperfections that might otherwise be seen through the skin. This can result in a smoother and more natural-looking breast appearance, especially for women with minimal breast tissue.

More Implant Coverage

One of the key benefits of submuscular placement is the increased implant coverage provided by the chest muscle. This extra coverage not only helps to create a more natural slope and contour but also contributes to a more balanced and proportional appearance. The muscle also acts as a buffer between the implant and the skin and provides additional support, helping to reduce the risk of visible implant edges for a pleasing look and feel.

Reduced Risk of Capsular Contracture

Capsular contracture is a potential complication that can occur following breast augmentation, characterized by the formation of excessive scar tissue around the implant. Submuscular placement has been associated with a reduced risk of capsular contracture. The presence of the muscle above the implant is thought to help minimize the development of excessive scar tissue by improving blood flow, which is crucial for optimal healing. 

Cons of Submuscular Placement

Some of the drawbacks of submuscular placement include a longer recovery period, temporary muscle discomfort and tightness, limitations on physical activity during the healing process and the potential for animation deformity when the chest muscles contract. During your initial consultation, our team will discuss these considerations in more detail to help you choose the best implant placement based on your needs, goals and preferences.

Somewhere In-Between: Subfascial Placement

The subfascial technique places the breast implants beneath the fascia, which is a thin layer of connective tissue covering the chest muscles. This placement option allows for partial coverage of the implant by the fascia while still maintaining some contact with the muscle.

Pros of Subfascial Placement

Some Extra Support & Coverage

The subfascial technique provides some additional coverage for breast implants compared to subglandular placement. The fascia also acts as a supportive layer, contributing to improved implant stability and reducing the risk of visible implant edges or rippling. This can result in a more natural appearance and smoother contours.

Less Distortion Caused by Muscle Movement

Subfascial placement involves many of the same benefits of submuscular placement, including improved implant coverage and a reduced risk of capsular contracture, but with less potential for distortions caused by muscle movement. The implant is not fully covered by the chest muscle, so your breasts will maintain their shape during physical activity. 

Improved Post-Op Comfort

The fascia is thin yet durable, enveloping the breast implant to support it and hold it in place. This extra support is also one of the main advantages of submuscular placement, but detaching the chest muscle along the ribs results in more post-op discomfort and a longer recovery. Subfascial placement provides a similar benefit with less pain and downtime.

Cons to Subfascial Placement

Subfascial placement provides some of the benefits of submuscular placement, but because the implants are placed beneath the thin fascia, this technique doesn’t provide the same level of coverage and support. As a result, there may be an increased risk of rippling and implant displacement over time. The procedure is also more difficult to perform than other methods. 

The Best of Both Worlds: Dual Plane Placement

The dual plane technique involves placing the upper portion of the breast implant beneath the chest muscle while allowing the lower half to sit over the muscle and behind the breast gland. This approach aims to take advantage of the benefits offered by both subglandular and submuscular placement options to achieve an optimal outcome.

Pros of Dual Plane Placement

Natural Slope & Position

One of the primary benefits of dual plane breast augmentation is the ability to achieve natural-looking results. The positioning of the implant beneath the muscle in the upper pole and behind the breast gland in the lower pole helps create a smooth and natural slope that enhances the overall breast contour. It can also result in a fuller appearance and provide some lift while reducing the tendency for the implant to “ride high” on the chest wall. 

Increased Implant Versatility 

Dual plane placement is a versatile technique able to accommodate a wide range of implant shapes and sizes, making it suitable for patients with varying needs and desires. This allows for a more customized and personalized approach to your breast augmentation surgery.

Reduced Risk of Rippling

Much like submuscular placement, the dual plane technique helps to minimize implant rippling. The breast implant is partially covered by the chest muscle to conceal any folds, wrinkles or edges, making them less noticeable. This helps to ensure natural-looking results, especially for women with less natural breast tissue to cover the implant.  

Cons of Dual Plane Placement

Dual plane placement offers significant advantages, but typically involves a longer surgical procedure and recovery period compared to some other placement options. There is also a slight risk of animation deformity when the chest muscles contract. During your initial consultation, our team will discuss the pros and cons of each placement technique in more detail to help you make the right decision for your breast augmentation. 

Other Factors to Consider

When it comes to breast augmentation, implant placement is just one important aspect among many to consider. Other factors, such as implant size, shape and material, as well as incision placement, will play an important role in determining the outcome of your procedure.

  • Implant Size & Shape: Choosing the right size, shape and profile for your breast implants is key to achieving your desired outcome. Factors such as your body proportions, existing breast tissue and personal preferences will be considered to ensure a result that aligns with your aesthetic goals.
  • Implant Material: Breast implants are typically filled with either saline or silicone gel. Each type has a unique texture, consistency and feel. Our team can guide you in selecting the best implant material for your needs and preferences.
  • Incision Placement: The choice of incision placement can impact the visibility of your scars. Common incision locations are under the breast fold (inframammary), around the areola (periareolar) and in the armpit (transaxillary). 

The recovery process should also be taken into consideration when planning your breast augmentation. Understanding the healing process, required downtime and expected postoperative restrictions will help you decide on the best technique for your needs and lifestyle, ensuring the best possible results from your procedure.

Schedule a Consultation With Indianapolis’ Breast Augmentation Experts

If you’re ready to take the next step toward your dream breasts, schedule a consultation at The Gillian Institute with board-certified plastic surgeon Dr. Kimberly Short, one of Indiana’s leading breast augmentation experts. We’ll guide you through the process of selecting the right implant placement, size, material and more to help craft your perfect bustline. 

To get started, contact us to schedule your consultation today! You can also call our downtown Indianapolis office at 317-787-3260, or our Northside location at 317-913-3260.