Minnesota Women Seek Breast Augmentation Part II By Brian Kobienia, MD, FACS on August 11, 2010

Choices For Placement

In our previous blog we covered the difference between saline and silicone gel devices.  There are two choices for implant placement: under the muscle and over the muscle (under the breast).  The choice is personal but there are some guidelines to help you choose.  Under the muscle is the most common placement.  This position has the benefit of hiding the imperfections of the implant that allow it to feel soft.  The skinnier you are the more likely you will feel the implant or see wrinkling through the skin.  In general the more subcutaneous fat the is the easier it is to hide the implants imperfections.

Below The Muscle

Another reason we often place implants below the muscle is to minimize tightening of the scar (capsular contracture) around the implant. One theory is that the built in massage of the muscle helps to keep the scar around the implant soft.

Submuscular placement of the breast implant also makes future mammogram interpretation easier.  This is important in breast cancer detection.
Having implants in does not increase your chance of breast cancer but can make mammograms more challenging.    

I believe that placing the implant below the muscle also can give you built in support to implant - almost like a built in brassiere.  If the implant is placed beneath the breast and not the muscle the weight of the implant is now held by the elasticity of the skin of the breast alone - this fails as time passes. Ultimately this may lead to a tennis ball in a tube sock look.

In addition, submuscular placement of the breast implant will give you a more naturally appearing breast.  This happens by limiting the fake look of the breast implant in the upper part of the breast.  You don't want your implants to advertise to the world that you had a giant jellybean implanted, you want the breast to look naturally bigger. 

Stay Tuned for more helpful hints.

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Dr. Brian J. Kobienia is a board-certified plastic surgeon who has been providing world-class care for nearly 20 years. When he is not working with patients, Dr. Kobienia is serving various local and global philanthropic programs. He is also affiliated with notable organizations including:

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