Breast Augmentation

Traditionally, when the majority of implants were silicone, implants were most often placed underneath the breast gland and on top of the muscle. With the use of saline filled implants, women who are thinner or who have relatively little breast tissue to cover the implants, have a tendency to develop “rippling” or a waviness in the skin overlying the implant. This is especially true with the use of the “textured” or rough surfaced implants. In an effort to decrease the incidence of rippling, there has been a move to place implants in the space beneath the pectoralis major muscle. Submuscular placement increases the padding overlying the implant offering more coverage and camouflage to the shape of the implant. Using this technique, rippling has become a rare problem

Today many more women have the option of silicone implants. Silicone implants are softer and the tissues tend to drape over them more realistically. They are also less prone to rippling. Consequently, it is possible to place them in a sub-glandular position more often while decreasing the risk of rippling.

There are, however, some breast shapes that are better suited to a sub-glandular (“over” the muscle) placement of the implant. These women typically have breasts that at one time were much larger than the present. When there is a very large volume decrease and there is little or no shrinkage in the size of the skin envelope surrounding the breast tissue, then the shape approaches that of an “empty bag”. Under these circumstances it is sometimes better to place the implant in a sub-glandular position in order to allow the implant to fill out the skin envelope of the breast.