The placement of the breast implant is entirely patient dependent. This means that the placement is tailored to individual patients based on their needs, lifestyle and anatomy.
Implants are generally placed in one of two areas relative to the breast. The first and perhaps most common placement is submuscular. Submuscular refers to placement underneath or deep to the pectoralis major muscle (the “pecs”). In this pocket, the muscle covers the upper 2/3 of the implant, while only the overlying breast tissue covers the lower 1/3.
Breast implants are usually placed underneath the muscle (sub pectoral pocket) in the majority of patients because of the advantages of this plane. These advantages include: lower rates of capsular contracture, better appearance of the implant edges, and maximal nipple sensation preservation. Disadvantages include: increased post-op pain, distortion of the implant shape with pectoralis muscle contraction (i.e. in weightlifters), unable to address moderate droopiness without a breast lift.
The other area of placement is subglandular, meaning underneath the breast tissue itself, but on top of the pectoralis major muscle. This pocket is also known as “pre-pectoral” placement of the implant. The pectoralis major muscle covers none of the implant.
In certain patients, most notably those with a bit of breast droopiness or ptosis, a sub glandular plane may be more desirable. Advantages of this placement include: easier plane to dissect, less post-operative pain and ability to compensate for a small amount of droopiness. Disadvantages include: increased rates of capsular contracture, increased bleeding during surgery and slightly greater chance of exposure to breast bacteria.