Women choosing breast augmentation often find conflicting opinions as to whether the implant should be placed in front of the muscle, and under the breast tissue, or beneath the muscle, between the ribs and the muscle.
The trend lately has been in favor of placing most implants beneath the muscle. However, there are exceptions when this may not be indicated. When breast augmentation began over 40 years ago the original implants were typically placed in front of the muscle. However since 1992 the use of saline implants became the standard and therefore most surgeons favored placing the implant beneath the muscle in order to minimize the affects of visible wrinkling especially in the upper portions. Silicone implants came back on the market for general use in 2006 and most surgeons continued to place the silicone implants beneath the muscle as well.
Although each case should be individualized, in my Pasadena plastic surgery practice, near Los Angeles, approximately 90% of breast implants are placed beneath the muscle. In my opinion most women who have minimal breast volume in the upper portions, and who choose saline implants, should elect to have implants beneath the muscle to give a more natural appearance. Most patients who choose silicone implants for the softer feel also elect to have them placed beneath the muscle if they have a lack of fatty breast tissue in the upper portions of the breast.
There is slightly more pain after surgery if the implant is placed beneath the muscle and the recovery can be slightly longer. Also, once the implants have settled into place the muscle can act as an aid in helping to massage the implants and keeping them soft. The only down side of placing them beneath the muscle is in thin patients who contract their pectorals muscle with heavy exercise or lifting. Occasionally it can be visible to see the inner portion of the breast contracting with this type of movement.
Please feel free to contact us to schedule a consultation in Pasadena California. In your consultation we can further discuss your individual needs with regards to Breast implants and Breast Augmentation.