There is a lot of decision-making that goes into planning your breast augmentation. Deciding on the type of implant is only one part of it. Another important decision to make is where the implant should be placed during surgery. In all breast augmentations a pocket is created somewhere behind the breast tissue in order to accommodate the implant, but whether that pocket is directly behind the gland, behind the gland and the muscle or a combination of the two is a decision that needs to be made in planning your procedure. There are a few options that can produce different results, so here’s a quick guide to how Dr. Plant determines which option is best for you.
In the case of the subglandular technique, the implant is placed directly behind the breast gland on top of the underlying muscles. This technique can produce the most increase in projection and nipple elevation, so this can be your best option if these factors are part of your goals. Implants using this technique can be more likely to demonstrate edge show along the top and are more subject to visible rippling if there isn’t enough breast tissue to cover them.
This technique places the implants underneath the pectoral muscle during surgery. As with all three techniques, the breast gland sits on top of the implant however in this case the pectoralis major muscle is also on top of the implant. Using the muscle to cover the implant can help to prevent rippling and edge show when the tissues are thin, however a total submuscular pocket is rarely used in aesthetic breast surgery anymore because it comes with a very high risk of superior malposition of the implant.
This technique can be considered a hybrid of the two above techniques and is by far the most common technique used by plastic surgeons currently. In this case, a pocket is created partially underneath the pectoral muscle and partially under the gland. The upper part of the implant is covered by muscle, which avoids edge show and can help give a more sloped appearance to the upper pole of the breast. The lower part of the implant is covered only by breast gland, which allows for fullness of the lower pole with a nice, soft rounded contour and an implant that sits directly within the footprint of the breast. There are varying degrees of this technique (Dual Plane I-III) that allow for different amounts of nipple elevation so it can be customized to your unique anatomy and goals.
If it feels overwhelming deciding on the many options that come with breast augmentation then be sure to speak with your plastic surgeon about your goals and concerns. While getting yourself informed is always a good idea, you should never have to make these decisions alone. A top-notch breast surgeon can help guide you through the process and make the best choices to suit you and your goals.
To schedule a consultation with Dr. Plant, contact our Toronto office by calling or filling out our online form.