Installation of breast implants: under the gland or under the muscle?

Installation of breast implants under the mammary gland

Each implant installation option has its own advantages and disadvantages. With a subglandular location, the endoprosthesis is located superficially, and therefore installation of breast implants under the mammary gland is possible only in the presence of pronounced subcutaneous tissue and good development of glandular tissue. In women with thin skin, the implant can be identified visually and feel different to the touch from the surrounding tissue.

Preoperative period:

So, the result of a preliminary consultation with a plastic surgeon is correctly selected endoprostheses, optimally selected access and placement of implants. The patient underwent a simple preoperative examination and consultation with an anesthesiologist who will administer anesthesia. No contraindications for breast augmentation were identified and the day of surgery was set. Due to the fact that breast augmentation is performed under general anesthesia, it is important to properly prepare for the operation. The doctor will give you preparation instructions, strict adherence to which will help the postoperative period proceed more smoothly.

Installation of breast implants under the large muscle

The problems listed above can be avoided through submuscular implantation. When installed under the major muscle of the chest, the implant is covered not only by glandular tissue and fiber, but also by the muscle and its fascia. Due to its deep location, the implant is almost impossible to notice either by touch or visually.

Installation of an implant under the pectoral muscle is actively used in modern aesthetic medicine. For implantation, submammary or axillary access is used. A relative disadvantage of the technique is more significant tissue trauma compared to subglandular endoprosthetics, as well as the risk of slight displacement of the implant if a woman is actively involved in strength sports.

Options for installing the Mentor implant

Placement of the Mentor implant

Mentor implants can be placed under the muscles of the chest wall (submuscular location) and on top of the muscle layer under the breast (subglandular location). The first method is the most common.

Submuscular location of the Mentor implant under the pectoral muscle

It’s worth clarifying right away that in this case we are talking about a partial placement of the breast implant under the pectoral muscle - approximately 2/3. It is in this case that the maximum aesthetic effect is achieved with a minimum of complications. The complete submuscular placement of the implant has a number of disadvantages: an unnatural shape of the breast in the lower part due to the location of the Mentor implant above the lower fold of the mammary gland; weak volume and height of the operated breast due to the density of the muscle hiding the implant. Therefore, complete placement of a breast implant under the pectoral muscle is done in rare cases; This method is especially contraindicated for women actively involved in sports.

The advantages of installing the Mentor implant under the muscle include:

the most natural appearance of the upper part of the breast, which is covered by the pectoral muscle, hiding the upper edge of the implant;
minimal risk of capusular contracture (formation of a very dense shell around the implant, which spoils the appearance and causes pain);
slight sagging of the chest,
lower risk of ripples or waves after installation of the endoprosthesis than with a subglandular location,
the implant is practically not palpable and does not interfere with taking clear images of the breast during mammography.

The disadvantage of this technique is that the duration of the operation and recovery period increases. After surgery, swelling may occur, which may subside over a long period of time (from several weeks to months). During active training, the implant may move slightly, but in general, this does not greatly affect the appearance.

This type of implant placement is especially suitable for slender, thin women with small breast volume and minimal breast ptosis.

Subglandular location of the Mentor implant

The method of placing a breast implant allows you to avoid affecting the pectoral muscle, placing the endoprosthesis above it and under the mammary gland. This option for installing an implant is suitable for women who have a fairly large volume of mammary glandular tissue - it allows you to hide the edges of the implant. It is also recommended for those who are actively involved in bodybuilding: significant contraction of the pectoral muscle during sports activities greatly deforms the implant - in this case it is better to place it above the muscle.

Advantages of the subglandular implant location:

reducing the duration of the operation and recovery period,
minimal swelling,
the implant does not change shape during sports.

Disadvantages of this arrangement:

it is not always possible to hide the contours of the prosthesis, which can appear through the skin,
it is difficult to achieve a clear image of breast tissue on an x-ray,
high risk of capsular contracture,
a large implant under the force of its own gravity can fall down, stretching the skin and contributing to the lowering of the breast as a whole.

In any case, the optimal location of the Mentor implant will be advised by a plastic surgeon after a comprehensive examination.

Advantages and disadvantages

The pros and cons of breast implant placement methods are not always obvious. The subglandular location of the endoprosthesis minimizes tissue trauma and has an easy rehabilitation period. The disadvantage of the method is that its application is limited due to the previously described features and the relatively higher risk of developing capsular contracture.

Installing an implant under the pectoral muscle gives an excellent aesthetic result, but is accompanied by significant tissue damage and requires a long recovery period. In addition, if a woman is engaged in bodybuilding, it is better to refuse submuscular implantation. The advantages include a minimal risk of fibrocapsular contracture and the ability to install an implant of any size.

SOHO CLINIC doctors always choose the optimal method for installing endoprostheses, based on the anatomical features and wishes of the woman. Make an appointment with a plastic surgeon and get answers to your questions during a free consultation.

Indications for surgery

Loss of breast volume and shape after pregnancy and lactation.
Reduction (hypomastia) and absence (amastia) of the mammary glands.
Condition after removal of the mammary gland (subtotal mastectomy).
Slight degree of sagging of the mammary glands.
Asymmetry of the mammary glands.
Condition after various operations that led to a decrease in the volume of the mammary glands.

Breast augmentation in our time is a simple operation, the essence of which is to install a silicone implant under the mammary gland or under the pectoralis major muscle. The operation is performed under general anesthesia, hospitalization after it is required for only two days, and a week after the operation you can go to work.

The success of the operation depends on three factors: the correct selection of implants, the skill of the doctor during the operation, and the patient’s careful compliance with all the doctor’s recommendations in the postoperative period.

Undoubtedly, the key to achieving the best result is the coincidence of the surgeon’s and the patient’s ideas about the ideal breast. One of the main tasks of the specialist is to find out what a woman expects from the operation and, in accordance with her needs, to offer the best option for choosing an implant, the method of its installation and the type of surgical approach.

There are two types of implants in shape: round and anatomical. Americans prefer a round breast shape - like an apple, equally convex on top and bottom. Europeans prefer the anatomical shape: smooth at the top and convex at the bottom - the way it is by nature. When installing round-shaped prostheses, after a few months it becomes noticeable that the breast is not your own, while anatomically shaped prostheses give the complete illusion of a real breast - a non-specialist will never notice that an operation has been performed.

The price of implants varies greatly, depending on the manufacturer, from 30 to 75 thousand rubles per pair. We use implants that, in our opinion, have the best price-quality ratio.

Different materials can be used, but preference is given to silicone. They are now completely safe. The problems that they had 15-20 years ago are long gone. Previously, indeed, there were often complications after surgery due to unfinished technology for manufacturing implants. Currently, there are practically no problems with implants. Those complications that may arise now are usually associated with patients’ failure to comply with the doctor’s requirements in the postoperative period. Modern prostheses are absolutely safe: they are very highly textured, are in a three-layer shell, which eliminates the possibility of rupture of the prosthesis or leakage of silicone; the inside is not liquid silicone, but a gel, which in consistency is like jellied meat; it does not penetrate or sweat through the shell. All prostheses come with a lifetime warranty from the manufacturer, i.e. even if some accident occurs (accident, injury), the patient has the right to a free implant replacement.

The prosthesis is placed through an incision of about 4 cm, which is located either under the breast, around the areola of the nipple, or under the armpit. Each method has its pros and cons.

Submammary - an incision in the anatomical fold under the mammary gland. This is the safest and easiest installation method. This approach provides the most direct route for the implant and requires the least amount of surgical time. The main disadvantage of this type of access is the presence of visible scars. They, of course, can be made almost invisible, but they will still be visible upon careful examination. Periareolar (transareolar) - the incision is located along the border of the pigmented part (nipple). This access leaves virtually no scars. If the adequate size of the prosthesis is selected and the operation is performed correctly, then there will be no traces left. This method is by far the most commonly used for mammoplasty. Axillary - placement of the incision in the axillary region. This approach allows you to avoid scarring on the chest after surgery. If the access is made correctly: along the natural fold, everything is cut correctly along the lines of force, then it will be invisible. The disadvantage of the axillary approach is that with it, the formation of a cavity for implant placement occurs almost blindly, which increases the risk of complications, but an experienced doctor can easily cope with this.

There are three ways to install an implant:

subglandular (the implant is installed under the mammary gland);
axillary (installation of a prosthesis under the pectoralis major muscle);
combined (the upper part of the implant is under the muscle and the lower part is under the mammary gland).

Which method to choose is decided by the doctor individually in each case.

After installation, the prosthesis gradually grows into the muscle - a capsule is formed around it within about a month, the process of breast formation itself lasts from 2 to 6 months.

At this stage, the correct behavior of the patient is very important. During the postoperative period, any physical activity on the upper shoulder girdle (swimming, tennis, push-ups, etc.), vertical load (running, horse riding), you cannot lift your arms above your head, carry weights, and you must wear compression garments.

Women decide to undergo mammoplasty for various reasons. Some people are initially dissatisfied with their breasts (shape or size), for many women the shape of the breasts deteriorates after pregnancy and breastfeeding, for others they sag with age, and another group of patients are women who have undergone a mastectomy (removal of the mammary gland).

Why do breasts droop after pregnancy and lactation?

During pregnancy, the volume of the gland increases very much, and then the so-called post-lactation involution occurs: the skin does not have time to contract, and a discrepancy arises between the volume of the filler and the area of the integumentary tissue - there is a lot of skin, but not enough filler, so the skin sags. In addition, the breasts themselves often become smaller after the lactation period. This quite logically follows the conclusion: in order to solve this problem, you need to either increase the volume of filler, or reduce the area of the skin, or combine both of these methods. If your breasts are very sagging, we offer mastopyxy – a breast lift. That is, the entire nipple areal complex rises to the level where it should be - this sometimes ranges from 15 to 22 cm.

We are successfully coping with this problem, although I would recommend trying not to let your breasts get to this state at all.

To do this, it is necessary to monitor the quality of your skin from the first month of pregnancy:

Visit a cosmetologist, massage therapist, use special creams, care products, wraps, undergo the LPG procedure, do a contrast shower. If the skin does not lose its firmness and elasticity, the breasts will return to their shape after childbirth.

After breast removal, it is also possible to restore a beautiful appearance.

Modern techniques make it possible to create a new breast in place of the removed one - the difference will be almost unnoticeable. The required skin is transplanted either from the tissues of the back or from the abdominal tissues, or the skin of the chest is stretched for several months with special endoexpanders, after which a prosthesis is placed. This is not a one-step operation, the process takes several months, but it is worth it.

Thanks to modern technologies - more advanced operating techniques and constantly improving quality of implants - this type of surgical intervention has reached a completely new qualitative level. Today it is a fairly simple and relatively safe technique for improving appearance.

Progress of breast augmentation surgery:

Breast augmentation with implants is performed under general anesthesia and lasts about 2 hours. The duration of the operation depends on the access used, the location of the implant and the technique used.

The implants are installed into a pre-formed cavity behind the breast or under the pectoralis major muscle through one of the above approaches (incision site). After inserting the implant into the formed cavity, the wound is sutured with a cosmetic suture. Absorbable sutures are usually placed and do not need to be removed. Sometimes they are supplemented with adapting sutures, which are removed after 2-5 days.

After breast augmentation surgery, the patient spends several hours to a day in the clinic. On the first day, a woman may feel slight pain in the chest and pain when moving her arms; The sensitivity of the breast to touch will be increased. During this period, the woman receives painkillers and, in some cases, antibacterial drugs. Then, after being examined by a doctor and bandaged, the woman can leave the clinic.

After breast augmentation:

Breast augmentation surgery imposes some restrictions in the postoperative period. A woman will need to wear special compression underwear (bra) for 30 days, which must be purchased in advance. 10-15 days after breast augmentation surgery, the swelling decreases and completely subsides, pain during movement disappears. Increased sensitivity of the breast to touch may persist for several weeks - this is normal. You will need to avoid heavy physical activity and sports for one month. You will be able to evaluate the final result of breast augmentation surgery in six months.