Breast Implant Placement

Mr Andrew Pieri MBBS MRES FRCS
Mr Andrew Pieri MBBS MRES FRCS

Specialist cosmetic & cancer breast surgeon

Table of Contents

Choosing to have a boob job is an exciting step for any woman. It’s an opportunity to transform your body and create the look you’ve always dreamed of.

Once you’ve decided to get breast implants, there are many other choices you need to make. Whether it’s choosing the right size breast implants or working out when to have a boob job to ensure you don’t have future issues with breast implants and pregnancy, you need to think long and hard about every aspect of the surgery before you go ahead with it.

A key consideration that many patients don’t fully understand is breast implant placement. As a leading provider of breast enlargement surgery in Newcastle, Mr Pieri understands how important this decision is. There are three main implant placement options, dual plane, subglandular placement and submuscular placement. Their names refer to whether the implants go over or under the main chest wall muscle, known as the pectoralis major chest muscle.

Choosing where to place your breast implants can affect the outcome of the procedure, so it’s vital that you make an informed decision. Before every breast augmentation surgery, Mr Pieri consults with the patient to discuss their goals and the best implant placement to achieve the desired outcome. To help you get started, here is a basic guide to breast implant placement.

The Anatomy Of A Breast

Diagram showing the internal components of a breast

Before discussing breast implant placement, it’s important to explore the anatomy of natural breasts. The breast sits on top of your chest muscle, also known as your pectoralis muscle.

When it comes to breast tissue, which makes up the area we usually consider to be breasts, there are three main types:

  • The glandular tissue, which is the functional tissue within the breast. This contains the milk ducts and glands for producing milk.
  • Fatty tissue, which is mixed in with the glandular tissue. Some people carry very little of their body fat in their breasts whilst others have significant changes in their breast size when they lose or gain weight, indicating a higher fat content in the breasts.
  • Finally, there’s the connective tissue, which connects the fatty tissue to the glandular tissue and helps your breasts retain their shape.

Each type of breast tissue serves a unique purpose and is an important part of the overall structure of your breasts. How much breast tissue you have is a major consideration when choosing the right implant placement.

Breast Implant Placement Options

Breast augmentations come in two main types: fat transfer and breast implant insertion. Fat transfers are usually used for particularly small size increases or simply to fill out a defect, an asymmetry or add a small amount of volume to the cleavage. For all but a subtle increase, women require breast implants.

Smooth implants or nano textured implants, like the ones Mr Pieri uses, are a great way to enhance your chest. Using round implants or teardrop implants, he can enhance your chest to create the perfect look for you. As well as breast augmentation, the implants can also be used for breast asymmetry correction surgery.

Whatever the outcome you want from your breast augmentation surgery, Mr Pieri can help you decide on the right implant placement for you. There are 3 main types of placement: over the muscle, under the muscle, or the dual plane technique. Each has its own advantages and disadvantages and is suited to a different look.

 

Over The Muscle (Subglandular Implant Placement)

Subglandular Positioning Breast Augmentation Surgery

Subglandular implants are placed over the top of the pectoralis major muscle and are a great option for the vast majority of women. Historically, it was difficult to provide a natural result with implants on top of the muscle, but with more modern implants, this is no longer the case for most women.

For women with very little tissue in the top of the breast, over the muscle implants might not be the ideal choice. The reason is that without plenty of soft tissue to cover breast implants, the implant’s surface contours can show through the skin, causing an effect known as “rippling”.

However, if you have larger breasts to begin with, then over the muscle placement can offer many benefits, including:

  • Provides a natural look for those with larger breasts to begin with
  • Can achieve your desired look quickly and reduce recovery time
  • Helps avoid future deformities and issues

Most surgeons prefer over the muscle implant placement, as this is often seen as a simpler procedure, but Mr Pieri knows that it won’t work for every patient. There are some risks to this approach, including more chance of capsular contracture, where the “capsule” of scar tissue thickens over time, creating a more unnatural aesthetic and sometimes causing discomfort.

Also, over time, the weight of the implant can have more impact on the skin (depending on the patient’s skin quality and elasticity). This can lead to “bottoming out”, which is where the skin below the nipple stretches, making the nipple appear higher on the implant. Another issue that can arise is known as a “rock in a sock” problem, where the skin above and below the nipple stretches, dropping the implant lower down.

To help you get the perfect look and reduce the chances of implications, Mr Pieri will discuss your body shape and requirements and then help you find the right implant placement option. He can explain whether or not subglandular placement will work for you or whether it’s worth exploring another position.

Under The Muscle (Submuscular Implant Placement)

Submuscular Positioning Breast Augmentation Surgery

The opposite of subglandular breast implants is submuscular placement, which is a technique that involves placing the implant underneath the pectoralis major muscle. With the implant covered by the muscle, it is further screened from the breast tissue, which can be ideal for women who only have a thin layer of tissue to begin with.

Without a thick outer layer of breast tissue, you might find that you get the rippling effect, which can make your breasts appear unnatural. With under the muscle placement, there’s a lower risk of visible rippling, as the implant is hidden by the breast muscle as well as the fatty tissue. This is a good option for women with less breast gland tissue who want larger implants. Also, there is a lower chance of capsular contracture with submuscular implants.

Some of the benefits of under the muscle breast implants include:

  • Lower chance of rippling or seeing the edge of the breast implant beneath the skin
  • Less likely to cause discomfort
  • Creates a natural curve to the top of the breast

While submuscular implants can be a great choice for those with smaller breasts to begin with, it isn’t without its risks. For women who enjoy strenuous activities, such as bodybuilding, implant movement on contraction (also known as “animation”) can increase your risk of lateral displacement, leading to a wide cleavage gap.

Results can take time to achieve with submuscular placement, and it can be more painful to recover from. Also, because the breast will inevitably sag to some degree with time, sometimes breast implants under the muscle don’t sag with the breast because the muscle separates them from the breast tissue. This can lead to a “waterfall deformity”, where the breast tissue hangs off the bottom of the implant that has remained higher on the chest.

Again, these issues aren’t guaranteed, but they can occur depending on your lifestyle and existing breast shape. Mr Pieri will help you to weigh up the pros and cons of this placement option vs the other two solutions available, and allow you to pick the best one for you.

Dual Plane Implant Placement

Dual Plane Position Breast Augmentation Surgery

The final breast implant placement option is known as dual plane implants. This technique acts as the best of both worlds, as it combines the attributes of the two other placement options to create a more natural look.

Mr Pieri conducts dual plane breast implant procedures by placing the upper part of the implant under the muscle. This approach reduces the risk of rippling in the cleavage and improves the aesthetic of the breast “take off”, or the way the breast begins, allowing a more natural angle where the upper chest meets the top of the implant.

At the bottom of the implant, Mr Pieri dissects the muscle fibres from the chest wall so that the implant is directly behind the breast tissue, thus creating the dual plane placement. Using this approach means that in the lower half of the breast, the implant can interact more directly with the breast tissue and skin, filling out any excess skin more effectively than it would with a true submuscular placement.

The benefits of the dual plane technique include:

  • Gives the breast tissue a lift for added volume and reduced sagging
  • Less risk of sagging in the future due to the weight of the implant being a little more supported
  • Provides a more natural look in patients with very little tissue
  • Mammograms often produce clearer results for women with dual plane breast implants

 

Woman holding her breasts as she considers breast implant placement

What Is The Most Popular Breast Implant Placement?

Mr Pieri has carried out many breast augmentation surgeries and has found that in the majority of patients more recently, with improvements in the technology of implants, over the muscle is the best choice in the majority when weighing up the risks and benefits of the options. However, this is an individualised decision that needs to be taken into consideration, including your personal situation, tissue measurements, and lifestyle.

Every patient’s lifestyle, current breast size and target look are all taken into account when deciding on the best placement option so that she gets the right results from the breast augmentation procedure.

Before the procedure, Mr Pieri will agree on a surgical plan with you to ensure that you get the right look from your breast implants. He will talk you through the right implant size and placement options to ensure you get the perfect outcome from the procedure. He can then help you understand breast implant surgery recovery; most women can get back to normal activities in a few weeks, but he can help you through every stage of recovery.

How To Choose The Best Implant Placement For You

Every patient’s lifestyle, current breast size and target look are all taken into account when deciding on the best placement option so that she gets the right results from the breast augmentation procedure.

Before the procedure, Mr Pieri will agree on a surgical plan with you to ensure that you get the right look from your breast implants.

When choosing an implant placement, the decision will depend entirely on your personal preference and current breast size. The key factor you need to consider is how much existing breast tissue you have. If you have larger breasts to begin with, then subglandular placement could help to create a naturally fuller look.

Those with smaller breasts and minimal breast tissue want to avoid visible rippling, so they might want to choose submuscular placement instead. Dual plane implants can sculpt the silicone implants around the chest muscles, creating a natural alternative.

Alongside the look you want, lifestyle factors can also affect where you choose to have your breast implants placed. For example, if you enjoy strenuous physical activity, such as bodybuilding, then under the muscle implants might not be a good option for you, as the contraction can cause an animation deformity.

When you choose to have breast implant surgery performed by Mr Pieri, you’ll get the benefit of his extensive knowledge of the procedure and longstanding experience in delivering breast enhancements in Newcastle and throughout the North East. In his initial consultations, he can help you decide on the right placement for your breast implants so that you get the outcome you’ve always wanted.

To begin your breast augmentation journey, email to find out more about the options available. If you want to get personalised information on the best implant placement for you from Mr Pieri, book a consultation today. 

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