Breast Augmentation Submuscular v's Subglandular

The  patient  considering breast  augmentation has  a  number of   choices. These include the location of the incision (in the fold under the breast, around the areolar border, or in the armpit areas), the type of breast  implant (silicone gel or saline, rough or smooth surface, and a variety  of degrees of projection and shape) and the location of the implant (under the breast or under the breast and the pectoral muscle).  At first glance it might seem that it would be more natural to place the implant immediately beneath the breast tissue.  After all, the operation is about enhancing the breast, not the muscle.  The reality is more complex.  In general, for patients with a relatively small amount of natural breast tissue, when the implant is just beneath the breast tissue (the subglandular plane), there will be an abrupt shadow in the upper part of the breast.  The breast that is created will tend to look top-heavy and unnatural.  This is particularly true in patients who select implants that are relatively large in comparison to the natural breast volume.  Also remember that the natural disadvantages of saline implants are more noticeable when they are in the subglandular plane.

 Most of the patients who undergo breast augmentation at the Whole BeautyTM Institute choose to have me place the implant in the space beneath the pectoral muscle.  This is called sub pectoral breast augmentation.  During the consultation I review the advantages of this location: a more natural look to the upper part of the breast, greater ease in getting good quality mammograms, and a lower likelihood of hardening around the breast implant (capsular contracture).  Although it takes me a little longer to create a proper space under the muscle, it is well worth it from the patient’s perspective.

Are there any disadvantages to placing the breast implant under the muscle?  For the first few days the recovery from surgery is a little more uncomfortable.  Also for highly athletic patients, especially body builders, contraction of the muscle will cause a temporary distortion of the breast shape.  For most patients these are minor disadvantages when compared to the advantages.

If you have small breasts and you encounter a surgeon who suggests placing a large implant in the subglandular plane, run the other way!  This is the closest thing possible to a guaranteed return trip to the operating room to fix the problems that will result from this.  Unfortunately, there are a number of implant “mills” where the emphasis is on speed of surgery rather than on producing a good long term result.  The patient who thinks she has found a “bargain” at such places doesn’t factor in the cost of repeated surgery to correct the problems that result from the first surgery.

There are some patients for whom the subglandular breast implant may be a reasonable consideration.  Patients who are body builders may find that the subglandular plane works best.  Also patients with a fair amount of natural breast structure who want to round out the upper portion of the breast many find this to be a reasonable choice.  Also, with certain breast shapes, the subglandular plane may work best when a breast augmentation is combined with a mastopexy (breast lift).

Cosmetic surgeon John Q. Cook combines knowledge and skill of unsurpassed quality with a sophisticated understanding of the nuances and subtleties of the natural form. His patients enjoy aesthetic treatments personally tailored to refine and rejuvenate their appearance while preserving their unique identity. A full menu of services is offered at our convenient plastic surgery centers in Chicago and Winnetka, from advanced surgical procedures at a state-of-the-art surgicenter or at Rush University Medical Center to quick recovery procedures performed under local anesthesia in the office setting to carefully designed treatments in a Medi-Spa setting. 
 

In our offices in Chicago on the Magnificent Mile of Michigan Avenue and on the North Shore in Winnetka,  we see patients from all over Chicago, including the Gold Coast, River North, Old Town, Near North, Lincoln Park, Lakeview, DePaul, The Loop, Logan Square,  Wrigleyville, Uptown,  Hyde Park,  Evanston, Wilmette, Kenilworth, Glencoe, Highland Park, Lake Forest, Lake Bluff, Deerfield, Northbrook, Northfield, Glenview, Barrington, , Mettawa and many other areas of the city and suburbs as well as patients from other states such as California,  New York, Michigan, Wisconsin and Indiana.  Patients also visit our practice from outside the country such as  England, Denmark, Greece, Ireland, and Japan to name a few. Visit wholebeautyinstitute.com.