Placement of Breast Implants
During the initial consultations with the client, the cosmetic surgeon will discuss the various surgical incisions that can be used through which the breast implants can be inserted into the chest. In addition the surgeon will discuss the anatomic placement of the breast implants: where the implants will be positioned in relationship to the breast tissue and the underlying pectoralis muscle. These choices, among others can have an effect on how the breasts will finally look and feel. The surgeon will explain to the client that there are generally two implant placement locations, subglandular and submuscular. The plastic surgeon wants the client to know what benefits and possible problems exist with these two placements, and why one choice may be better for this particular client. There may be specific reasons why a particular placement will work better in each case.

Subglandular Implant Placement
What works well for one woman may not be the best choice for another, but subglandular placement will probably involve less post-operative pain. Since the breast implant is inserted between the breast tissue and the underlying pectoralis muscle, there is less traumatized tissue, so pain is lessened and healing is faster. While many consider this to be the ideal placement of the breast implant because it more closely aligns with the real breast tissue, the surgical candidate will be informed of the risk of rippling or capsular contracture (especially in smokers). There is less of a risk in women with ample overlying tissue. Women who opt for this form of placement are advised that the accuracy of mammography may be diminished and any breast enlargement operation may require additional mammography views to be made in order to view the breast tissue.

Submuscular Placement
In cases of breast reconstruction, where complete coverage of the breast implant is important, the prosthesis is implanted beneath the pectoralis muscle. This type of placement can result in a more natural feel and appearance, less likelihood of sagging and shrinking of the true breast tissue, fewer complications, such as capsular contracture, and more successful mammography imaging. The price that the client pays for these benefits will be more post-operative discomfort and a longer healing period. Infection at the surgical site is always a risk but can be minimized with fastidious cleaning and changing of bandages after surgery.

Conclusion
While rippling and contracture can occur more frequently in subglandular placement, the procedure takes less time, is less painful, and surgical revision is easier. The submuscular technique offers the woman a more natural look and feel, and a diminished risk of complications, but takes longer and involves more pain. Each procedure has its ideal candidate and no single placement technique fits all women. Although some plastic surgeons have a favorite placement approach, discuss your concerns with your doctor to understand why one technique may be the best for you. Both techniques are equally practiced and receive nearly the same favorable evaluation by clients. Being prepared with questions about breast implant placement for the surgical interview can prepare you to make these decisions with more certainty.