Making the choice to move forward with breast augmentation is made up of many different considerations -saline or silicone, shaped or round, location of incision and last but not least implant placement. When choosing implant placement you have two options, above or below the muscle.
“Most surgeons performing breast augmentation should have the knowledge and ability to place the implant either above or below the pectoralis muscle” says Dr. Greenwald.
When considering placing the implant over the muscle there are pros and cons to consider. Because pre-pectoral placement is considered “easier” and less invasive, patients typically experience shorter recovery times and less post surgery discomfort. Additionally, when the implant is above the muscle there is generally more cleavage due to the implants being placed slightly closer together. However, implants placed above the muscle can appear less natural-looking. The implants may also have less support in this position making it easier for stretching to occur and can also make rippling more visible. Additionally, patients who have above the muscle implants have an increased risk of capsular contracture and “bottoming out” could occur.
Sub-pectoral placement, implants placed under the muscle, are more commonly recommended and preferred by plastic surgeons. Below the muscle placement tend to give a more natural appearance as the implants are covered by both breast tissue and the pectoral muscle, which also reduces the risk of visible rippling. Additionally, the support of the muscle helps reduce the stretching of the skin and reduces capsule contracture. If your plastic surgeon advises you may benefit from a breast lift in the future, below the muscle might be a better choice to avoid any complications with blood supply to the nipple. Because sub-pectoral placement is considered slightly more invasive, patients can sometimes experience slightly longer recovery times and increased post-surgery discomfort. For the first 6 weeks after surgery, implants placed below the muscle may appear to sit a bit higher until the pectoralis relaxes. “When considering the best placement for your desired outcome it is best to consult with your plastic surgeon,” says Dr. Greenwald.
To schedule a consultation with Dr. Greenwald to learn more about your breast augmentation options, contact his practice by calling (914) 421-0113 or (212) 518-1642.
