By Jerome Edelstein, MD
Breast augmentation involves the creation of a pocket that allows for the placement of the breast implant. The pocket can be made in one of two places: under the breast itself (sub-mammary or sub-glandular), or under both the breast and chest muscle (sub-pectoral or sub-muscular).SUB-MAMMARY POCKETIn sub-mammary implant placement (also known as sub-glandular), the breast implant is placed between the breast tissue and the chest muscle.
This position is frequently recommended for women who already have a fair amount of breast tissue. They may also have a mild degree of breast droopiness (ptosis). A moderate amount of breast tissue will help conceal an implant placed in a sub-mammary pocket. In addition, a mild amount of breast droopiness can be corrected.
Sub-mammary pocket placement is also recommended for women with unusually shaped breasts, as the implants will help to change the shape of the breast better than implants placed in a sub-pectoral pocket.
Finally, professional, competitive body builders and fitness models are usually better off with implants placed above the chest muscle as well.SUB-PECTORAL POCKETIn the sub-pectoral approach (also known as sub-muscular), the implant is placed under both the breast and chest muscle. The chest muscle covers the upper two thirds of the implant, while the bottom third is covered by your natural breast tissue. This allows for a tear-drop shape to the breast that looks more natural.
Generally speaking, sub-pectoral placement is more common than sub-mammary. The subpectoral breast implants are recommended for women who have minimal amounts of existing breast tissue. Because the chest muscle covers the majority of the implant, it will act like extra padding, making the implant less visible through the skin and ‘feel-able’. Other advantages of sub-pectoral placement include a lower risk of capsular contracture (a condition that is characterized by an undesirable hardening of the breasts), and making mammograms easier to read (which can be beneficial for a woman with a family history of breast cancer).
Keep in mind that there is no single approach that is ideal for every patient. We will help you decide which implant pocket placement is best for you prior to surgery, taking special care to select one that will achieve your personal goals and expectations.