In the last few years, an alternative to traditional implant position has been described. As opposed to the simple over or under the pectoralis muscle decision, a technique which places the implant over the muscle but under the muscle fascia (covering tissue) has interesting properties that offer several benefits.
- Subfascial placement prevents the “bolted on” appearance often caused by the submuscular placement, offering a more natural slope to the breast similar to traditional subglandular implant placement.
- Has a lower rate of visible wrinkles or “rippling” than the pure subglandular position.
- Less disruption of the patient’s anatomy than the submuscular or partial submuscular positions, as the pectorlais muscle is not released off of the chest wall.
- Significantly less discomfort early after surgery. Generally, patients can return to work after a 2 or 3 days and are able to resume workouts early on.
- Prevents the muscle “animation” of the implant that is often visible after submuscular placement in extremely active or thinner individuals.
In patients with enough tissue to consider this type of surgery, I am increasingly recommending this approach to patients considering breast augmentation.