When a woman thinks about having breast augmentation with implants, she has three choices where the implant is positioned:
- Over the chest muscle
- Under the chest muscle
- Under the thin, tough sheet of tissue, the fascia, covering the chest muscle
All three have their advantages and disadvantages so no one position is right for every patient.
The basic drawbacks to the subglandular position over the chest muscle are:
- Any rippling in the implant can be seen and felt through the skin
- Mammography is more difficult
- Capsular contracture, a painful scarring and hardening of the breast is more common
- Implants are more likely to fall down into the breast pocket, or, “bottom out”
But the procedure, also known as the submammary placement, is quicker for the surgeon to do, involves less recovery time and, most likely, less expense. If something goes wrong with the implant later, it’s easier for the surgeon to reach.
When a plastic surgeon puts an implant under the chest, or, Pectoralis muscle, he or she usually cuts the muscles in half, creates pockets, places the implants and sutures the chest muscles back. That creates more recovery time and expense because the technique is more difficult to master. (Note: muscle cutting can be avoided by entering the breasts through the armpits.)
But a larger implant may be required because the chest muscle presses down on the implant.
However, the technique also offers:
- Low risk of capsular contracture
- A softer and more natural feel
- Rarely seen bottoming out
The third option, placing implants under the fascia, also has many advantages, according to an article in the October, Aesthetic Plastic Surgery, a publication for cosmetic plastic surgeons.
Three plastic surgeons in Nuevo Leon, Mexico, reviewed the records of 1000 breast enhancement patients over 10 years who had soft gel breast implants placed under the fascia covering the chest muscle.
The surgeons entered 95 percent of the breasts through an incision in the inframammary fold, the area under the breast at the chest wall.
The surgeons/authors found:
- Less post-op pain
- A shorter operation
- Quicker return to daily activities
- Better projection (how far out in front the breast projects)
- Reduction of capsular contracture
- Less morbidity than subglandular and submuscular methods
(Read the fascia breast augmentation article.)
admin @ November 17, 2009