BREAST IMPLANT POSITIONS
…. which implant position will be best for you?
Breast Implants can be placed in any one of four positions each of which has its specific advantages. Which implant position is best for you will depend on your breast appearances, breast measurements, physical activities and the ‘look’ you’re after.
1. Sub-Muscular (‘under the muscle’)
The implant is placed behind the pectoral muscle.
The advantages of the Sub-Muscular position include:
- It creates a more natural appearance because the muscle provides additional coverage over the edges of the implant and thereby helps to avoid a ‘stuck-on’ look and visible ‘step’ along the upper edge of the implant that could occur if the implant was ‘in front of the muscle’ in those with thin tissue coverage.
- There is less chance of Capsular Contracture – the commonest reason for repeat surgery.
- There is less chance of any Rippling/Wrinkling of the implant being visible.
- There is less interference with Mammograms.
- There is less chance of interference with future breast feeding.
- The implants are further away from the breast tissue and are therefore less likely to be involved in any breast diseases or be damaged during any fine needle biopsy of a breast lump.
2. Pre-Pectoral (‘in front of the muscle’)
– sometimes called Sub-Glandular
The implant is placed immediately under the breast tissue itself, between it and the underlying pectoral muscle.
It is preferred to sub-muscular:
- In those with impending or mild sagging of the breasts, constricted lower breast poles and Tuberous Breast Deformities.
- In those engaged in heavy, repetitive pectoral muscle exercises e.g. body builders, weight lifters.
However, it is not a good option for those women with thin chest wall tissues as the insufficient coverage of the implant edges would create an unflattering ‘stuck-on’ appearance.
(‘in front of the muscle’ but ‘under its sheath’)
This is simply a variant of the ‘in front of the muscle’ position with basically the same advantages and disadvantages.
4. ‘Dual Plane’ Placement
A combination of positions 1 and 2 where the upper half of the implant is placed ‘under the muscle’ and the lower half is in direct contact with the lower breast.
- The upper half of the implant is placed ‘under the muscle’ to help hide any ‘step’ along the implant’s upper edge that could occur if the implant was entirely ‘in front of the muscle’
- The lower half of the implant is in direct contact with the breast to provide ‘fill’ and ‘lift’.
- This implant position is preferred in special situations such as mild sagging, constricted lower poles and Tuberous Breasts when there is insufficient chest wall tissue coverage to allow the implant to be placed entirely ‘in front of the muscle’.
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Frequently Asked Questions
There are basically four:
• ‘Under the Muscle’ (Sub-Muscular)
• ‘In Front of the Muscle’ (Pre-Pectoral, sometimes called Sub-Glandular)
• Sub-Fascial (Under the Sheath of the Muscle)
• Dual Plane (partly ‘Under’ & partly ‘In Front’ of the Muscle)
Each position has its pros and cons, but unless there is good reason to not use it, we prefer the Sub-Muscular position because it delivers a more natural ‘look’ due to the extra tissue coverage over the edges of the implant. In contrast, the ‘In Front of the Muscle’ position can deliver a ‘stuck-on’ appearance if there is insufficient tissue coverage to hide the implant edges, or if the patient subsequently loses weight and exposes the implant’s edges.
Understandably, ‘Under the Muscle’ does take a little longer to do than ‘In Front of the Muscle’, but our aim has always been to deliver the best possible ‘look’ for each patient. Some surgeons use the ‘In Front of the Muscle’ position routinely. It’s quicker and easier for the surgeon, but for us, it’s about placing the implant where it will deliver the best ‘look’, not what’s quickest and easiest!
The other positions, Sub-Fascial & Dual Plane, are reserved for special circumstances. Our Surgeon will explain which position would serve you best, and why, at your initial consultation.
The Sub-Muscular position holds the following distinct advantages:
• It delivers a more natural ‘look’ because the muscle provides additional coverage over the edges of the implant and helps to avoid a ‘stuck-on’ look.
• There is less chance of visible Rippling/Wrinkling
• There is less chance of Capsular Contracture.
• There is less interference with Mammograms.
• There is less chance of interference with future breast feeding.
• The implants are further away from the breast tissue and are therefore less likely to be involved in any breast diseases or be damaged during any fine needle biopsy of a breast lump.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.