Not All Breast Implants Need to be Placed Under the Muscle

Breast augmentation is a popular cosmetic procedure that involves the placement of breast implants to enhance the size and shape of breasts. While the traditional approach has been to position the implants beneath the chest muscle (submuscular placement), it is important to recognize that this technique may not be suitable for every patient.
Understanding Submuscular Placement:
Submuscular placement involves positioning the breast implant beneath the pectoralis major muscle, which lies between the breast tissue and the chest wall. This technique offers advantages such as increased tissue coverage, reduced risk of capsular contracture, and improved visibility during mammograms. However, it is not the only approach, and there are scenarios where alternative placement options may be more appropriate.
Sufficient Breast Tissue:
Patients with adequate natural breast tissue may not necessarily require submuscular placement. If there is already a significant amount of breast tissue, it can provide ample coverage for the implant, resulting in a natural and aesthetically pleasing outcome. In such cases, subglandular placement (positioning the implant beneath the breast tissue but above the muscle) may be a viable option.
Ptosis (Sagging):
When a patient has breast ptosis (sagging), submuscular placement may not be necessary. Ptosis refers to the descent of the breast tissue, and if it is mild, subglandular placement can adequately address the patient’s goals without the need. This approach can also yield a shorter recovery period and less post-operative discomfort.
Athletic or Active Patients:
Patients who lead an active lifestyle or participate in sports may prefer subglandular placement to submuscular placement. Placing the implant above the muscle can minimize movement and distortion of the breast during physical activity, leading to increased comfort and reduced risk of implant displacement.
Patient Preference:
Ultimately, patient preference plays a significant role in determining the implant placement. Some individuals may simply prefer the aesthetic outcome achieved with subglandular placement, as it can provide more projection and a defined upper pole. Open communication between the patient and the plastic surgeon is crucial to understanding and meeting the patient’s desired outcome.
The notion that all breast implants must be placed submuscular is a common misconception. While submuscular placement offers certain advantages, it may not be necessary or appropriate for every patient. Factors such as existing breast tissue, ptosis level, activity level, and patient preference should be taken into consideration when determining the optimal implant placement.

It is essential to consult with a qualified and experienced plastic surgeon who can assess your unique circumstances, discuss the available options, and guide you toward the most suitable approach for achieving your desired breast augmentation results. By understanding the various placement options and dispelling myths, patients can make informed decisions and achieve beautiful and personalized outcomes that align with their specific needs and goals.