What’s Better? On Top of the Muscle or Underneath?
On Top or Below the Muscle? Too Much Compression if Above?
A recent research study published in the Aesthetic Surgery Journal concludes that patients who undergo breast augmentation by placing the implant directly underneath the breast gland (and on top of the muscle) may experience more loss of breast gland/tissue over time.
They hypothesized that the findings they discovered on MRI scans were possibly due to the pressure the implant was putting on the blood vessels going into the breast tissue. With enough compression, this diminished blood flow could cause shrinkage of the breast gland. The expert commentary that followed the article stated that the MRI data might be a little inaccurate and that we shouldn’t accept these assumptions entirely. More studies were recommended.
Nonetheless, I have been a very active proponent of placing the implants underneath the muscle for three important reasons:
- #1 the implants are harder to see and feel if they are deep and covered by muscle. Rippling (which is the ability to see the outline or edge of the implant contour underneath) is much less of an issue in this location.
- #2 the risk of developing a tight scar around the implant (called a contracture) is lower.
- #3 mammograms are easier for the radiologist to interpret when the implant edge is separated from the overlying breast tissue by the muscle layer (this goes back to my years as a general surgeon when I took care of ladies with breast cancer). Understandably, breast form AND overall breast health are very important to me.
If you’re interested in learning more about your options for breast augmentation from an experienced and trusted plastic surgeon, please fill out our request for consultation form or call the office for a visit. We can be reached Tuesday-Friday from 9am-5pm at 801-479-5722.