The technique breast implants under the muscle, or more commonly referred to as submuscular implant placement, positions the device under the chest muscles to achieve these goals:
- Additional soft tissue coverage
- More natural contour / more teardrop shape
In patients with small breasts or low body fat percentage (e.g., female athletes and body builders), the risk of visible scalloping especially around the implant’s edges is higher than women with ample amount of soft tissue coverage. The same is also true for individuals who have had mastectomy or breast cancer surgery.
The most effective way to eliminate or at least minimize the risk of scalloping in thin and small-breasted women is to use the submuscular technique. In addition, this implant placement has been known to reduce palpability and firmer feel due to the additional soft tissue coverage.
For patients with very little coverage, breast implants over the muscle, or subglandular technique, can lead to less than optimal results. Some even have described their breasts to feel and look like a stiff water balloon; this problem is further aggravated by the use of large saline implants.
Saline implants are filled with sterile salt water, so most doctors prefer to position them underneath the muscle, particularly if there is little soft tissue coverage. Silicone implants, meanwhile, contain a more cohesive filler material that almost feels like the glandular tissue and fat.
Proponents of the submuscular technique suggest that it promotes better shape—i.e., the upper cleavage appears relatively concave while the bottom half looks rounder. While anatomical or teardrop implants may also simulate this look, they pose a risk of flipping over and causing deformity.
Round implants, which in essence are shaped like a flattened sphere, do not pose the same risk as the anatomical implants. And once inside the breast pocket, the gravitational effects turn their innate shape into something that resembles a teardrop, thus obviating the need for a “real” teardrop implant.
But with the introduction of form-stable, highly cohesive silicone implants (gummy bear implants or fifth generation silicone implants), the “teardrops” are making a comeback, according to Los Angeles plastic surgery analysts.
To recap everything, the submuscular placement favors women with little tissue, especially if they are using saline implants. However, the technique remains a viable option for patients with ample coverage and prefer silicone implants.
The subglandular technique, meanwhile, is [almost] only used in patients with sufficient breast tissue who are using silicone breast implants.