A breast implant can be placed OVER or UNDER the pectoral muscle. Although most patients get the UNDER option, some benefit from going OVER.
UNDER is most common because of it’s many benefits, most importantly the lower capsular contracture rate
OVER is an option for patients who do not want to disturb their pectoral muscles and who do not want their implants to move when they flex their pectoral muscles.
Breast Augmentation surgery involves the creation of a pocket that allows for the placement of the breast implant above or below the chest muscle (pectoralis major). The pocket can be made in one of two places: under the breast itself (also known as sub-glandular or sub-mammary), or under both the breast and chest muscle (also known as sub-muscular or sub-pectoral). There are also three different methods through which a sub-muscular placement can be made.
A sub-muscular approach to Breast Augmentation can be performed through a complete sub-muscular or partial sub-muscular implant placement.
In the complete sub-muscular placement the implant is completely covered by the muscle and is unable to descend. This is ideal for women with smaller, flatter breasts and no sagging. When sagging is present, the chest muscle is cut and released from the ribcage at the bottom (along it’s inferior insertion), allowing the implant to sit lower than would otherwise be possible, and therefore avoid the formation of a double bubble deformity.
A sub-muscular pocket placement is more common than a sub-glandular placement, and is recommended for women who have minimal amounts of existing breast tissue. In such women, the chest muscle acts as a padded cover over the majority of the implant, so that it is less visible through the skin.
When a breast implant is placed in a sub-glandular pocket, the implant sits between the breast tissue and the chest muscle.
A sub-glandular pocket placement is used only in women who have the moderate amount of breast tissue necessary to conceal the implant. It is recommended in women who have a mild degree of sagging (ptosis) or unusually shaped breasts. Sub-glandular implants help to change the shape of the breast more effectively than implants covered by the chest muscle in a sub-muscular pocket.
Dr. Jugenburg often performs dual-plane Breast Augmentation as it provides a beautiful, natural breast enhancement, even in women with very little existing breast tissue. In this approach, a Round breast implant is positioned below the chest muscle (pectoralis major) and partially below the breast tissue overlying the muscle, thereby giving the benefits of both a sub-muscular and sub-glandular pocket placement. This is achieved by releasing the bottom of the chest muscle (pectoralis major) from the ribcage (the inferior insertion) and the bottom of the breast tissue from the muscle to allow the bottom third of the implant to sit lower than the muscle in a sub-glandular position.
The uneven compression from the muscle across the implant creates a gentle, natural teardrop shape to the breast. Shaped implants (also known as Teardrop or Anatomic implants) would further exaggerate this effect in an unnatural way and are therefore not used with this approach.
The benefits of a dual-plane implant placement are:
During the consultation process, Dr. Jugenburg will examine you and explain to you which breast pocket placement will give you the best results. There is no single approach to implant placement that is ideal for every women. The placement and technique that Dr. Jugenburg uses for your Breast Augmentation will be chosen based on your existing anatomy and to meet your desired goals. Factors that may determine the best approach for you include:
For personalized advice on your breasts, please call us today on (647) 360-1975 to schedule your consultation.