What Is Submuscular Breast Augmentation?

Submuscular breast augmentation is one of the most commonly performed breast augmentation procedures carried out by cosmetic surgeons.

So if you get this type of procedure done, then you can be relatively confident knowing that your surgeon knows what they are doing and have had plenty of practice doing that procedure on other women.

This is an important consideration to make, because some forms of breast augmentation surgery, such as transumbilical breast augmentation, are carried out much less often. As a result, it can be harder to find a cosmetic surgeon who is well-trained and experienced in that procedure, which then increases the risk of something going wrong or you getting a bad result.

How Does Submuscular Breast Augmentation Work?

The basic surgical procedure involves inserting the breast implants that you have chosen underneath the pectoral muscles, which are composed of the pectoralis major and pectoralis minor.

The pectoral muscles sit on either side of the chest with the breasts sitting on top of them. Pectoral muscles are what men try to exercise, because it makes their chest look bigger and more muscular. When these muscles are well-developed in men, they could be said to resemble female breasts.

The implant will be positioned underneath the muscle, with a little bit sticking out at the end that is covered by breast tissue, skin and fat to provide a lift for the tip of the breast in the case of a dual-plane or subpectoral augmentation.

One of the reasons why this has been such a popular method for inserting breast implants, is that because the implants are being inserted underneath muscle and above the chest wall, the end result is a very natural looking lift to the breast.

Type Of Incision

The type of incision that is used when inserting submuscular breast implants is called an inframammary incision, which is basically just another name for a crease or fold incision.

The location of the incision will therefore run along the crease of the breast where the breast meets the chest. An incision in this area will allow easy access to the pectoral muscle, whilst at the same time minimizing the amount of visible scarring that is left after the procedure has been completed.

To insert the breast implant, a small incision is made nearby the inframammary fold so that the pectoral muscle can be lifted from the chest enough for the implant to be inserted into a pocket underneath it.

Generally, only part of the implant will be covered, in which case, the procedure is called a partial submuscular implant. It can also be called a subpectoral or dual plane breast implant placement. When the whole of the implant is covered by the pectoral muscles, it is referred to as a complete submuscular or full submuscular implant placement.

Once the implants have been inserted underneath the breasts, the incisions will be stitched back up with absorbable stitches. The incisions may also be taped up with a steri-strip or surgical tape, or alternatively with tissue glue, to keep the skin on either side of the incision wound together.

You may also receive a bandage wrapped around your breasts for support, although not all patients will be given this as it largely depends on the size of the inserted implants and whether the surgeon feels a bandage is necessary. Otherwise, the patient will be instructed to wear their bra home.

How Long Does The Procedure Take?

As this is a fairly routine type of cosmetic surgery it should only last for about 2-3 hours, although some breast surgeons may be able to finish it sooner.

The procedure itself can be carried out under general anesthesia in a hospital operating room, which is usually the preferred option, or in a surgery center or surgical suite. In the large majority of cases, providing that your operation has gone well and that you have not suffered from any complications, you will be discharged the same day to return back home.

Advantages Of Submuscular Breast Implants

One of the main advantages of having this type of breast augmentation surgery is that because the implants are placed underneath the pectoral muscles, the end result appears much more natural and it is less obvious that you have had implants inserted into your chest.

With other types of procedures, such as subglandular augmentation, you may be able to see or feel the implant along the side of the breast, and if the procedure was done poorly, you may even be able to see an outline of the implant underneath the skin!

With a partial sub-muscular placement however, these problems are largely eliminated. Although unless you have a complete sub-muscular placement, you may still be able to feel the lower portion of the implant as that will only be covered by breast tissue and not muscle.

In addition, because incisions are made under the crease of the breast, no breast tissue will be damaged during the procedure. This also means that no breast ducts will be cut and so you will be able to produce milk normally if you have children. The resulting scar will only be visible if you lift your breasts up, otherwise they will be well hidden.

Capsular Contracture

Another advantage of submuscular breast augmentation is that there is less risk of developing what is known as a capsular contracture, which is a relatively common complication that can occur with breast surgery.

A capsular contracture involves two things happening. The first, is the formation of scar tissue arround the implant which is called a capsule. The formation of a capsule around a breast implant is normal, as it is the body’s way of trying to defend itself from an invading foreign object.

A capsular contracture occurs when the scar tissue of the capsule begins to contract, which then has the effect of squeezing the breast implant. This can be a problem because your implants may then become hard or be squeezed into a different shape causing your breasts to look irregular or misshapen.

The risk of a capsular contracture tends to be much lower when either a complete or partial sub-muscular procedure is carried out, as the implants are inserted underneath muscle rather than on breast tissue.

The Good

A submuscular breast augmentation placement is ideal for women who are seeking a natural looking result and a result that feels natural to the touch. This procedure is also especially well suited for women with small breasts or little breast tissue.

The breasts will look bigger and fuller without it being obvious that you have had cosmetic surgery, and due to the location of the implants, they shouldn’t interfere with medical examinations of the breasts such as when checking for breast cancer lumps or when having a mammography exam.

Disadvantages Of Submuscular Breast Implants

No surgery is perfect, so it is important to accept that despite having many advantages, no matter how good a particular procedure is, it will always have some disadvantages associated with it.

One such disadvantage is the amount of pain or discomfort that you will experience after your procedure. Due to the sub-muscular insertion of the implant, this is inherently a much more invasive type of surgical procedure.

As a result, it will take some time before your muscles have stretched enough to accommodate the implants that have been inserted below them, which can also cause it to take longer for your implants to fall into place in the pocket that the surgeon has created for them.

This means that overall, your recovery period is going to take longer and it will also take longer before your breasts look normal. So you will have to wait awhile for your breasts to settle down before you are able to judge the final result of your surgery.

But for most women this shouldn’t really be too much of an issue, as eventually, you will make a full recovery, and when you do, you will have natural looking breasts. So the extra wait will be worth it for most.

Moving Breasts

Perhaps the most common concern that women have with submuscular breast implants is whether or not their breasts will move after surgery. Unfortunately, the answer to this is yes. As the implants have been inserted underneath the pectoral muscles, when those muscles are contracted, it can cause the breasts to bounce or “dance” similar to how a man with large pectoral muscles can make his pecs dance.

However, you needn’t worry about having your breasts dancing on your chest every time you move your arms or lift something, as it will only really be noticeable when you deliberately flex your chest muscles. There may be some movement when lifting objects, such as when lifting a shopping bag, but the movement will usually be so subtle that nobody will notice.

Finally, with partial submuscular breast implants there is a risk of the implant “bottoming out”, which basically means that the implant slips too low on the chest. This can cause one breast to look lopsided or cause the nipple to be positioned irregularly. There is greater risk of this happening with larger implants due to the heavier weight.

The Bad

For most women, submuscular breast implants will produce very good results. However, this type of cosmetic procedure tends to be more suited for women with smaller or fuller breasts that are of equal size, as it can produce less natural looking results in women with sagging breasts or breasts which obviously differ in size or shape.

There is also the disadvantage of having your breasts “dance” when your pectoral muscles are tensed, which may cause some women to feel self-conscious and possibly also attract unwanted attention from the opposite sex.

Lastly, the longer recovery time will mean you being in discomfort for longer, and also having to take more time off work to make a full recovery and for your breasts to look as they should do.