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There are two common breast implant placement options. Your implant can be placed behind your breast above the muscle (submammary placement), or behind the pectoralis major muscle in your chest (subpectoral placement). About 60% of cosmetic surgeons prefer submammary placement, and the other 40% prefer subpectoral placement. Dr. Bellin prefers and recommends submammary placement except in extremely rare circumstances.
Dr. Bellin prefers submammary placement for the following reasons:
- It is more aesthetically pleasing – A correctly placed implant should look perfectly natural over the muscle. Placement behind the muscle, if not done perfectly, can result in too much upper fullness that not only looks unnatural, but may cause your nipples to appear to point down. This effect is more likely to happen if your breast implants are placed from an incision under your arm.
- You have the option of local anesthesia – Submammary placement can be performed with intravenous sedation and local anesthesia which is safer and less expensive. Subpectoral placement always requires general anesthesia and/or a complex sequence of nerve blocks.
- You preserve your pectoralis major muscle – During a subpectoral placement surgery the inner attachment of your muscle must be cut to allow space for your implant. This creates an increased risk of bleeding and also severely weakens your pectoralis major muscle, which is your main chest muscle.
Dr. Bellin has removed sets of implants placed behind the pectoralis major muscle by other surgeons and put them in front of the muscle because they had looked so abnormal. In each of these cases, the pectoralis muscle was paper thin, having been destroyed by either the pressure of the implant underneath it, or by the muscle becoming detached. If your muscle is not attached at both ends it cannot contract, cannot be exercised, and then it is severely weakened. Cutting your muscle also increases your risk of bleeding after your surgery.
- You feel natural – Advocates of subpectoral placement think that it causes less capsular contracture or apparent hardening of the implants. Some studies have shown this to be true, but others have not. A colleague of Dr. Bellin’s who has done over 5,000 augmentations has placed implants in both positions and strongly believes that there is no difference in the hardness of the breast implants due to what is known as capsular contracture.
- You have minimal pain – Subpectoral placement is very painful and necessitates strong narcotics for a week and frequently two, as well as a week away from work. With a submammary placement you will experience minimal postoperative pain. Strong painkillers aren’t typically needed and you can return to work in two or three days.
Subpectoral placement has some advantages if breast cancer is a concern. If it is, Dr. Bellin will discuss this with you during your breast implant consultation.
If you are interested in getting breast implants, please contact us today to arrange your free breast implant consultation.