Implants can be placed over the muscle or under the muscle. If it is placed over the muscle, it is called a subglandular placement. This is because the only tissue covering the implant will be the woman's breast gland. The other option is to place the implant under the muscle (submuscular). The muscle referred to in this case is a muscle called the pectoralis muscle. It is the main muscle of the chest and is located directly beneath the breast gland. These options are shown in the diagram on this page.
The most common placement is submuscular. In order for the implant to fit under the muscle, and for the appearance to be aesthetically pleasing, some muscle fibers must be detached from the inferior ("bottom") of the breast and from the corner of the middle portion of the muscle ("inferior-medial"). The remaining attachments of the muscle are strong enough to allow full function of the muscle.
Once the muscle fibers are detached to allow the implant to fit under it, the muscle will move upward slightly. You can see this in the diagram. The bottom of the muscle is no longer located at the bottom of the breast. Instead, the bottom of the muscle is located near the middle or lower 1/3 of the implant. Thus, the upper portion of the implant is covered by the muscle and the lower half or 1/3 of the implant will not be covered by muscle. The lower part of the implant will be covered by breast tissue and gland only. This is why a submuscular placement is also called a "dual plane." It's a "dual" plane because two kinds of tissue are covering it.
Placing the implant under the muscle has several advantages. The muscle provides more coverage and cushion over the implant. This creates smoother contours, a more natural look, and prevents rippling or edges from being seen. Another advantage is that a submuscular placement has been shown to decrease the risk of capsular contracture. During your consultation, Dr. Diaz will discuss all of the options and will help you decide which placement will be best for you.
Click on the video above to learn more about the placement of the
implant under or over the muscle.