There are many reasons to consider a breast implant procedure - you may be unhappy with the way your clothes fit, you may have unevenly shaped or lopsided breasts, or you may need a reconstruction after surgery or an accident. Whatever the reason, most people don't make the decision to have breast surgery without considering all the pros and cons. One of the decisions you will need to make is placement of the implant. This article discusses what the options are and their individual advantages.

How are the implants inserted?

Breast augmentation involves placing an implant behind each breast. The implant is a saline or silicone gel-filled shell that is designed to feel like normal breast tissue. The implant shell itself is made from surgical-grade silicone or polyurethane, and the filling can be either saline (salt water) or silicone gel.

There are three options for inserting the implant. The surgeon can make an incision (cut) in the skin:

• under the fold of the breast (where your breast meets the upper abdomen) to hide any scars that may occur when the incision has healed
• in the armpit
• on the outer edge of the areola (dark skin around the nipple).

Your surgeon will advise you on the best placement option and where the incision will be made, based on what is the most suitable option for you.

Once the incision is made, the surgeon creates a pocket for placement of the implant and closes the wound with internal stitches.

Position of the implants

The position of the implants depends on several factors, such as how thick the breast tissue is and how well it will cover the implant once it is in place. The type and size of implant may also affect decisions on placement. There are three options for placement of implants:

1. Submuscular - under the pectoralis major muscle of the chest wall

Submuscular placement reduces the risk of visibility or palpability of the changes associated with capsular contraction, a complication of all breast implants which can result in the breast feeling hard and uncomfortable. Submuscular placement also results in a more natural appearance of the breast.

2. Subglandular - under the breast tissue and on top of the pectoralis major muscle

Subglandular implant placement has a quicker recovery time than Submuscular placement. It is a good option for women who have adequate upper pole volume to cover the implant, physically active women who use their pectoral muscles in sport or weight training because muscle function won’t interfere with the implant. Subglandular implants are also recommended for women with mild breast sagging from pregnancy/breast feeding or weight loss as it can specifically augment loss of upper pole fullness. Subglandular placement is less ideal for women with a thin chest wall and for women with inadequate soft tissue cover at the upper pole.

3. Muscle split placement - combination submuscular and subglandular

In this technique, the upper half of the implant is placed under the muscle, and the lower half remains in front (but under the breast tissue). This placement provides a good breast lift and fill of the lower breast, but hides the edge of the implant under the muscle at the top.

Ultimately, your surgeon is the best person to guide you on decisions about placement of implants. He or she can advise you on all the different options available so that you get the best result for you and the way you want your breasts to look.

Next Step

If you are considering breast augmentation surgery and have questions you would like to ask, or if you would like to book a confidential consultation at a cost of $140, click below or call (03) 9088 5000 for the Melbourne practice or (07) 3180 3400 for the Brisbane practice. The Cosmetic Surgery Co-ordinators of NorthEast Plastic Surgery will organise a consultation with Mr Tansley or Dr Seneviratne who are highly qualified and experienced surgeons. They will assess your individual requirements and discuss your preferences in regard to breast augmentation surgery.