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Breast implants behind the muscles is a technique in which the devices are covered and supported by a thick layer of chest muscle, in addition to breast tissue, fat, and skin. For this reason, the surgical maneuver favors women with little soft tissue coverage to begin with.

Dr. Tarick Smiley, a reputed Beverly Hills plastic surgery expert, explains the pros and cons of breast implants behind the muscles, a technique medically referred to as submuscular.

What Is Subfascial Technique (above-the-muscle) And Dual-Plane Technique (under-the-muscle)?

When it comes to breast implant surgery, there are two main methods that surgeons use. A skilled surgeon, who is certified by a board, knows how to do both. They decide which method to use based on what each patient needs.

The first method is called the Subfascial Technique, also known as the above-the-muscle method. With this method, the implant goes behind the breast tissue but stays above the chest muscle. It’s good for making the results look natural while still giving enough support.

The second method is the Dual-Plane Technique, which is also known as the breast implant under-the-muscle method. Here, the implant goes behind both the breast tissue and the chest muscle. This way, there’s less chance that the implant will be visible, and it can stay stable for a longer time.

The choice between these methods depends on each patient’s situation. The surgeon looks at things like the condition of the patient, the type of tissue they have, and what they want the outcome to be. Then they pick the best method to make sure the patient is happy with the results.

Under-the-muscle Vs. Over-the-muscle Breast Implants

When you’re thinking about getting breast implants, you’ll have to decide if you want them over or under the chest muscle. Over-the-muscle implants go on top of the chest muscle, while under-the-muscle implants go beneath it.

Both types have their pros and cons. Over-the-muscle implants might mean a faster recovery and a more noticeable upper breast shape. However, they could be more visible and have a higher chance of issues like capsular contracture. Breast implants under the muscle might look more natural, reduce the risk of visible rippling, and offer better long-term support. However, recovery might take a bit longer, and there could be temporary changes in shape when you flex your muscles.

Understanding these differences helps you make a smart choice based on the results you want.

Pros Of Breast Implants Behind The Muscles

breast implants pros and cons
  • Natural slope to the top of the breast

Studies have suggested that the ideal breast shape has a ratio of 45:55, with the nipple-areola as the demarcating line. This means that the lower pole should appear fuller than the upper pole to achieve natural results from implants.

The submuscular, together with the proper placement of implants both vertically and horizontally, will result in a more natural breast profile and shape.

  • Less risk of palpable and visible rippling

Due to the added coverage, the risk of rippling is significantly reduced, which makes the technique ideal for small-breasted and “athletic” women. However, it remains important to use an implant size that is within what the underlying anatomies can handle.

  • Less risk of inadvertent displacement

The chest muscle acts like an internal bra that will support the new contour and the bigger cup size. For this reason, women with a history of ptosis (sagging breasts) are generally advised to choose the submuscular and avoid the sub-glandular, in which the implants are on top of the muscle, with only the tissue and skin “carrying” them.

Cons Of Breast Implants Behind The Muscles

  • More postop pain

Compared to sub-glandular, placing the breast implants behind the muscle results in longer recovery and more post-op pain. However, most patients feel that the long-term benefits far outweigh the temporary discomfort.

  • Limited implant size

Since the muscle will only stretch to a certain degree, particularly in first-time patients, the breast implant size might be limited. But for women who want a natural look, this is not an issue as smaller augmentation is the key to achieving such a goal.

Also, smaller implants tend to minimize the risk of bottoming out or inadvertent displacement, palpable rippling, longer recovery, and scar migration.

  • Appearance of muscle distortion when flexing the chest area

While this type of “deformity” does not bother most patients, it may not sit well with bodybuilders who have well-developed muscles and are required to flex their chest muscles during competition, leading to the appearance of high-riding implants, but only momentarily.

Conclusion

Whether to choose breast implants behind the muscles or not depends on different factors such as body shape, desired appearance, and lifestyle. Consulting with a qualified surgeon like Dr. Tarick Smiley can help patients make the best choice for their individual needs. Understanding the advantages and disadvantages of each option empowers patients to make informed decisions to achieve their desired results while minimizing risks and complications.

Dr Smiley

Regarded as the preeminent plastic surgeon in Beverly Hills, Dr. Smiley performs groundbreaking cosmetic procedures with a combination of delicacy and accuracy. He has gained worldwide recognition as a prominent figure in the field of plastic surgery.