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What is the difference between subglandular, submuscular and subpectoral breast implant placement?

For breast augmentation surgery, subglandular refers to the breast implant being placed under the breast tissue but over the muscle. Submuscular refers to the breast implant being placed under the muscle of the chest wall. Subpectoral (or partially submuscular) refers to the breast implant being placed under the pectoralis major muscle only. This leaves 1/3 of the lower, outer implant not covered by muscle tissue but by the breast gland.

Which method is best?

For breast augmentation, whether to place the breast implants subglandular, submuscular or subpectoral is determined by the natural shape of the breasts and chest wall muscles and is different for everyone. However, in most cases of breast augmentation, the preferred placement is in a submuscular position for several reasons:

  1. The breast implants tend to look and feel more natural due to more tissue covering the implants.
  2. breast implants in a submuscular plane have lower risk of capsular contracture,- this occurs when the body develop scar tissue around the implant. Capsular contracture can change the shape of the implant and result in an asymmetrical look.
  3. This method also results in less disruption to the normal breast tissue and nerves, and makes mammographic examinations easier.
  4. Because the breast tissue is separated from the breast implant by the muscle, the quality of a mammography exam is much better.
  5. Though submuscular implant placement is a bit more uncomfortable, it reduces the possibility of sagging due to weight loss or pregnancy since the muscle will support the implant.

What type of incisions can be used for breast augmentation?

  1. Transumbilical – through the navel
  2. Inframammary – under the breast fold
  3. Transaxillary – through the arm pit
  4. Peri-areolar – around the nipple-areola complex
  5. Mastopexy – made for a breast lift
  6. Through a scar or abdominal incision

The goal of any surgery is to minimize the size of any type of incision. Most patients with symmetrical breasts are good candidates for a transumbilical breast augmentation (TUBA). However, when it is necessary to change the shape of the breast, an inframammary incision allows enhancement of cleavage and/or the correction of breast asymmetries. Areolar incisions are best performed when breast augmentation and breast lift procedures are combined.

What is inframammary breast augmentation?

Inframammary breast augmentation uses a 1.5 inch incision that is placed at the mammary crease. Through this incision, the breast implant pocket is prepared and the implant is placed within the pocket. This approach leaves a thin scar within the mammary crease which is concealed by the augmented breast. If secondary surgery is ever needed, the surgeon can use the same mammary crease incisions. The inframammary incision is the most popular incision used for breast augmentation in the majority of cases.

What is transumbilical breast augmentation?

Transumbilical breast augmentation (TUBA) leaves a virtually unnoticeable scar since the incision goes through the belly button. A small fiber optic camera called an endoscope is used to see while a tunnel to the breasts is created and a dissection is made under the chest muscle. An expander is inserted and saline solution pumped into it in order to shape the breast. The final implant replaces the expander.

What is peri-areolar breast augmentation?

Peri-areolar breast augmentation makes an incision at the junction of breast skin and the pink areola. The incision is then extended through the breast tissue to the chest muscle. Implants can be placed above or below the muscle. If a secondary surgery is needed, the surgeon can use the same incision. Peri-areolar breast augmentation is suitable for women who require a small breast lift through a crescent mastopexy.

What is transaxillary breast augmentation?

Transaxillary breast augmentation involves a small incision in the armpit, or the axilla, through which the implant is inserted. Implants can be placed above or below the muscle. An endoscope is sometimes used to allow for a more direct placement of a submuscular implant. Transaxillary breast augmentation often takes longer to complete than other approaches since the procedure is more involved.

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