Answers
"Can you please explain the differences in procedure, recovery time and effect between implants behind the muscle versus behind the breast tissue? Which one is more widely used?"
— Answered by Jay Pensler, MD
Chicago, IL
Breast augmentation requires the placement of an implant through a small incision beneath the breast tissue to enhance the shape of the breast. The implant may be placed directly beneath the glandular tissue (subglandular) or beneath the glandular tissue of the breast and beneath the pectoralis major muscle just beneath the breast (submuscular). As a general rule, implants that are placed below the muscle result in slightly more discomfort postoperatively. However, this discomfort is easily controlled with pain medication in the typical patient. Submuscular implants have more tissue between the implant and the skin (muscle + breast) than those placed below the glandular tissue alone. The appearance is slightly different from implants placed subglandularly, so you may want to look at pre- and postoperative photos. It is generally felt that placement of the implant under the muscle makes it easier to obtain a good-quality mammographic x-ray of the breast. However, women who work out a lot may feel that placement of the implant under the muscle gives the breast an unnatural appearance when lifting weights. As to which approach is superior, it is up to the patient and her plastic surgeon to discuss the pros and cons of each and to make the best choice for the individual patient based on anatomy, the surgeon’s experience and the patient’s desires.
