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    Breast Implant Pocket Placement

    Breast Implants | Breast Augmentation Beverly Hills | Los Angeles

    A breast implant can be placed in three primary pocket locations: subglandular (underneath the breast mound and above the chest muscle), submuscular (underneath the chest muscle) and partial submuscular/dual plane (partially underneath the breast mound and partially underneath the chest muscle). There is no ideal implant pocket placement, but there are certain advantages and disadvantages to having the breast implant placed in the different pocket locations.

    Subglandular Placement: The major advantage of subglandular implant (i.e., above the muscle or underneath the breast mound) placement is less post-operative tenderness/recovery since the chest muscles are not involved in the surgery.  However, some major disadvantages include increased risk of implant rippling and palpability in women with thin breast tissue since subglandular placement offers less coverage of the implant as well as an increased risk of developing capsular contracture. Also, subglandular placement of the implant often leads to a more fake appearance of the breast since the roundness and projection of the implant is more evident visually than when the implant is placed underneath the muscle.  Lastly, some surgeons feel that subglandular placement of breast implants helps to lift and reshape the breast mound more than submuscular placement in some cases.

    Submuscular Placement: Although all early breast augmentations were performed by placement of silicone gel-filled breast implants in a subglandular (above the muscle) pocket, it was noted that sometimes the breasts began to appear slightly unnatural due to implant rippling, palpability and capsular contracture (scar tissue formation). Therefore, the submuscular (under the muscle) breast augmentation technique was developed to help lower the incidence of capsular contracture, provide a more natural breast mound appearance and decrease implant visibility, palpability and rippling due to improved implant coverage/camouflage. The disadvantages of submuscular placement were a possibly longer recovery period, increased post-operative tenderness due to partial release of chest muscle and sometimes a “high-riding “placement of the implant within the chest pocket. The dual plane approach to breast augmentation was developed to help address this last disadvantage and to help improve the overall shape of the submuscular breast pocket by allowing the breast implant to settle into the lower breast fold more naturally (see below).

    Dual Plane (partially below and partially above the chest muscle): The dual plane breast augmentation is the most contemporary breast augmentation technique currently being performed today. As stated above, this technique was developed as patients and surgeons began to notice that purely submuscular placed breast implants tended to shift upward and laterally (towards the armpits) over time.  The solution was to release the chest muscle attachments at the lower pole of the breast in order to relieve the upward and lateral forces of these muscles on the breast implant. Therefore, in this technique the upper half of the breast implants remains covered by the chest muscle (submuscular) while the lower half of the implant  is allowed to settle underneath the breast mound (subglandular) in the lower pole of the breast near the breast fold (i.e. dual plane/pocket). In this way, the high-riding look of the purely submuscular approach is avoided and the breast implant sits in a more natural position in the breast pocket. This technique can also help to lift the areola to a higher position on the breast mound as well as prevent constrictions of the lower pole of the breast that can cause such problems as creation of a double bubble deformity. In addition, there is no need to try and push the breast implants down into the lower pole of the breast after surgery since breast implant settling occurs more naturally and almost immediately after surgery with the dual plane technique.

    To find out more about breast augmentation please contact us at 310-246-2355

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