When patients come in to see us for a consultation regarding a breast augmentation cosmetic procedure, we will go over all the steps for the procedure, what to expect afterward, and any special pre-surgical instructions. Also, we will discuss options for silicone versus saline implants, the technique to insert the implants, and the implant size and profile (the height versus circumference of the implants). We will also discuss whether the implants should be placed in front of the chest (pectoral) muscles but behind the mammary glands (subglandular) or the chest muscles (submuscular). Each has its pros and cons, which are determined by the results that the patient wants and their physical frame and skin thickness.
Pros to Subglandular Placement of Breast Implants
Perhaps the most significant advantage for subglandular implant placement is reduced pain during the immediate post-surgical period compared to submuscular placement. Furthermore, patients will have a faster recovery period and see the final size and shape of the implants sooner than with submuscular implants.
Regarding which type of patient may be better suited to subglandular placement, we feel that women who already have somewhat large breasts will be better candidates since there is already an adequate amount of breast tilace to cover the implants fully. Women with either excess skin or a small to moderate amount of breast droop may also be good candidates for subglandular placement.
Cons to Subglandular Placement of Breast Implants
The most significant disadvantage to the subglandular placement of breast implants involves cases where there may not be enough skin and breast tissue to cover it adequately. An excellent example of this would be patients with small breasts or thin skin. In such cases, the implants may be easier to both see and feel. Any rippling will be more visible with subglandular implants. The breasts will also have a more round, bubbled appearance, which some patients may not want.
Furthermore, subglandular implants carry a greater risk of capsular contracture. The scar tissue that naturally forms around the pocket into which the implants are placed becomes excessively thick and hard, causing the breasts to have a hardened feel. This may also contribute to the implants having a higher risk of bottoming out or shifting too far down on the chest if the capsular contracture pushes the implants too far down. If a patient experiences capsular contracture from subglandular implants, Dr. Marin may have to do a second surgery to remove some of the excess scar tissue.
Each patient will have different needs. A subglandular placement may be best for one patient, while a submuscular placement may be the better choice for another patient. Dr. Marin will collaborate with the patient on which placement location will give them the look they want and reduce the risk of any complications at a later date.
*The content in this blog is developed to spread the awareness towards plastic surgery. Our blog is not intended to serve as a replacement for an actual in-office consultation with Dr. Marin. As such, the information within this blog reflects the unique cases of our individual patients.