By plastic surgeon Dr Dirk Kremer. 

So, you’ve decided that breast implants are for you. Following a great deal of time weighing up the pros and cons, along with digging into plenty of research, you’ve come to the conclusion that undergoing a breast augmentation procedure will be the right option. 

However, during your extensive research you discovered that there are different places that the implants can be placed - different places within the breast? Yes!

This naturally means you have even more research to do and it is the reason you are reading this article right now. Fortunately, you are in the right place, because I am going to go through the different implant placement options for you right now and highlight some of the pros and cons with each method.

Most breast augmentation procedures involve one of the two more traditional methods.

These are commonly referred to as over placement or under placement. It sounds like a simple enough decision to make, but it’s actually very technical, not to mention there are a selection of other options for a patient to consider.

Let’s go through the options:

Subglandular implant placement

Subglandular placement, commonly classed as ‘over’ placement, is when breast implants are placed between the breast tissue and pectoral muscle.

The pros and cons to subglandular implant placement are as follows:

Pros to Subglandular

• Generally a shorter recovery time
• The procedure is usually a lot easier than other placements
• Post-op recovery tends to be more comfortable for patients
• Ideal placement for women with a moderate amount of breast tissue
• Decreased risk of implant distortion

Cons to Subglandular

• Not an ideal choice for saline breast implants
• Results may appear less natural on women with minimal breast tissue
• Prone to visible ripping potentially occurring over time
• Not an ideal implant placement if breast tissue is minimal

Dual plane implant placement

Dual Plane is otherwise referred to as ‘under’ placement - though the implant doesn’t sit entirely underneath the breast muscle tissue. The upper section of the implant is placed underneath the pectoral muscle, but the lower section remains uncovered. Some plastic surgeons may also refer to dual plane as partial sub muscular, sub pectoral, or the split muscle technique or split pectoral technique - so it does have quite a few names within the cosmetic industry!

Learn more about my signature Split Muscle Breast Augmentation procedure.

Pros to Dual Plane

• Can help greatly improve breast asymmetry
• Can add a little lift to the breasts
• Results tend to look very natural
• Risk of an implant sagging is reduced
• Easier to perform a mammogram
• Risk of the implants rippling is reduced
• Risk of capsular contracture is reduced

Cons to Dual Plane

• Surgical procedure is more complicated than some other placements
• Post-op discomfort may be more painful
• Prone to visible ripping potentially occurring over time
• Breast implants may be prone to distortion
• May take a little while for chest muscle strength to recover post-op

Submuscular implant placement

Submuscular implant placement is when the breast implant is entirely placed underneath the pectoral muscle. It’s one of the lesser used methods by cosmetic surgeons, as you’ll find out by the cons far outweighing the pros, and if a surgeon refers to the placement as being under the muscle, they usually mean either a dual plane or split muscle placement - but do ask if unsure!

Pros to Submuscular placement

• Reduced risk of an implant rippling

Cons to Submuscular placement

• Implants may feel quite tight
• Implants sit higher on the chest
• Prone to changing shape over time due to arm and chest movement
• Potential for patients to develop chronic pain or discomfort
• Recovery time tends to be longer post-op
• Procedure is a lot more complicated than other placements

Subfascial implant placement

Another less common method is subfascial implant placement. This involves the breast implant being places beneath a thin layer of fascia, which is the connective tissue that covers the pectorals. The fascia is extremely thin, which can make the procedure difficult to perform as it isn’t always easy to cover the entire implant.

Pros to Subfascial placement

• Reduced risk of capsular contracture occurring
• Risk of breast implant rippling is reduced
• Results are very natural in appearance
• Post-op discomfort tends to be less than other implant placements

Cons to Subfascial placement

• The procedure is very difficult to perform
• May be an increase in bleeding compared to other methods
• No long-term comparative studies are yet available
• There is the potential for trauma during the separation of the fascia tissue

Have you been considering breast augmentation? If so, don’t hesitate to get in touch with me here at Harley Street Aesthetics so that we can discuss the procedure with you in more detail. You can book your initial consultation with me by calling 0845 519 72732, e-mailing info@harleystreetaesthetics.com or by completing the online contact form.