Breast Implant Placement
Breast augmentation is one of the most frequently requested cosmetic plastic surgery procedures. Breast implants can provide a wide range of correction, whether you are considering breast enlargement to provide volume for under developed breasts, or you want to restore breast volume lost after child bearing or weight loss. There are many facets to consider with breast enhancement: Size, Filler (Silicone or Saline), Shapes, Profiles, Surface (Smooth or Textured), Placement, Incisions and Postoperative Activity. All these should be considered before the plans for Breast Augmentation are finalized.
Dr. Mele uses several different Breast Augmentation techniques. This allows him to choose the method that can give you the best Breast Augmentation results in the safest and most predictable way possible. A personalized, in-office consultation appointment is the only way to choose the most appropriate path to your breast enhancement. Below is some basic information to help you understand your options.
Placing breast implants behind the pectoralis major muscle has several advantages. The overall shape of the breast is more aesthetically pleasing. Muscle compression at the top of the breast gives a more tapered look. The result is a full, natural, teardrop shaped breast. The muscle also adds thickness to the soft tissue covering the implant. This not only helps to better disguise the breast implant, but also protects the implant.
When the breast implant is behind the muscle, mammography is enhanced. The breast tissue is in front of the muscle and is more easily manipulated for mammography. When the implant is in front of the muscle, it will block more of the breast tissue, and prevent areas from being visualized on the mammogram.
In the past, the capsular contracture rate for silicone filled implants was lower when the breast implants were placed behind the muscle. The difference is less pronounced with the introduction of low bleed silicone gel implants in the mid 90's.
Breast implants placed above the muscle have less soft tissue to disguise the fact that breast augmentation has been performed. You will see the outline of breast implants placed in front of the pectoralis major muscle more easily. This is sometimes referred to as the "fake look". The extreme case can be found on the cover of many muscle and fitness magazines. Since most fitness models have very little body fat, they tend to have very little natural breast tissue, and breast implants placed in front of the muscle give a round breast.
The advantage of placing the implant in front of the muscle is that the breast implant is not likely to move with forceful flexion of the pectoralis major muscle. So if you are a body builder, and you are posing, breast implants in front of the muscle will not move like implants placed behind the muscle. Also, small amounts of sagging can be disguised, by placing the implants in front of the muscle. While this will not require additional incisions like a breast lift, it will mean a breast slightly lower on the chest wall.
The dual plane technique is a hybrid technique that attempts to combine aspects of breast implant placement in front of and behind the pectoralis muscle. For carefully selected patients, this technique maintains the tapered appearance of the upper pole, while allowing for better filling in the lower pole. This can be helpful when there is some laxity in the lower breast, but cannot replace a breast lift.