Where is the implant placed?

a. In a subglandular placement, the implant is placed under the breast tissue and above the muscles of the chest wall. The thickness of your breast tissue and it’s ability to adequately cover the implant is one factor that determines whether this placement is used. Subglandular placement may make surgery and recovery shorter and less painful.   This placement may result in more palpable implants, more capsular contracture, and more difficult imaging of the breast with mammography.

b. In a partial submuscular placement, the implant is placed under the breast tissue and partially under the pectoral and other chest muscle. The surgeon will cut the pectoralis major muscle and slip the upper part of the implant under that, while the lower part of the implant is placed above the muscles and beneath the breast. This placement may result in less palpable implants, less capsular contracture, and easier imaging of the breast with mammography.

c. In a complete submuscular placement, the implant is placed completely under the muscles and connective tissue called fascia. The upper portion of the implant is behind the pectoralis and serratus muscles, while the lower part is under connective fascia connecting those muscles. Submuscular placement may be more painful, and may make it more difficult to have some reoperation procedures than the subglandular placement.

Three main options are available for incision location: under the breast (inframammary), in the armpit (axillary), and around the nipple (periareolar). The choice of incision used depends on whether this is a first implant or a revision surgery, type and size of implant being used, scarring, and other factors. Incisions are always made where the scarring will be least noticeable. Discuss these options with Dr. Porterfield as each have advantages and disadvantages.