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One of the most common questions asked by clients to perform breast prosthesis surgery Prosthesis is:
Under the muscle (subpectoral) or on the muscle (subglandular)?
Choosing the right place to place the prosthesis is a very important and specialized issue that depends on the anatomical conditions of the person's body, the amount of fat tissue and breast tissue, lifestyle, physical activity level, and the patient's aesthetic goals.
In this context, there are false beliefs among some applicants that need to be clarified.
common beliefs and scientific facts
Many applicants, without a specialist evaluation, tend to place the prosthesis under the pectoral muscle and think that this method will prevent breast sagging in the future.
This is one of Believe It's false about cosmetic surgery.
But according to the opinion of many reputable plastic surgeons around the world, placing a prosthesis under the muscle is recommended only in certain circumstances.
For example, if the thickness of the breast tissue in the upper part is less than 2.5 cm or there is a slight sagging of the breast, placing the prosthesis under the muscle helps create a more natural appearance and avoid touching or defining the edges of the prosthesis.
Capsular contracture and the importance of choosing the correct place of the prosthesis
One of the rare but important complications in breast prosthesis surgery is capsular contraction (capsular contracture). In this case, the body creates a hard tissue around the prosthesis, which may cause pain, change the shape of the breast and discomfort.
In this situation, one of the treatment methods is moving the prosthesis under the muscle.
Therefore, if the prosthesis is placed on the muscle from the beginning, in case of capsular contracture, there is a chance that the problem will be solved by changing the position of the prosthesis under the muscle.
But if the prosthesis is placed under the muscle from the beginning, in case of this complication, it will not be possible to use this solution and more complex surgeries may be needed.
athletes and choosing the right place for prosthesis
In professional athletes who have strong and active pectoral muscles, it is recommended to place a prosthesis on the muscle. Because the placement under the muscle in these people may lead to a change in the shape of the prosthesis during muscle contraction, discomfort, or even functional impairment.
Read more: all Things about exercise after breast implants
difference between pain and recovery
In terms of pain experience and recovery period, usually patients who receive the prosthesis under the muscle report more pain in the first days after the operation.
On the other hand, people who have prostheses on the muscle usually have a shorter recovery period and have minimal pain.
Summary
Choosing the location of the breast prosthesis is a completely specialized decision and should be done by an experienced surgeon based on the specific conditions of each person.
In the office of Dr. Behzad Farrokhi, after a detailed examination and checking your needs and expectations, the most appropriate method will be chosen to achieve the best result from the surgery.
Full comparison of advantages and disadvantages
Features / Placement Under the muscle (subpectoral) On the muscle (subglandular) Appearance of the prosthesis More natural, softer to the touch, the edges are less visible Visibility In people with enough fat tissue, natural / in thin people it may look artificial Chance of touching the edge of the prosthesis Very low More, especially in thin people Post-operative pain and recovery More, due to involvement Less muscle and faster recovery Suitable for athletes Less recommended More convenient because pectoral muscle is not involved Effect on mammography Less disturbance May hide tissue on mammography Slow Possibility of capsular contracture Less More Possibility of re-surgery in the future Less, if it is first under the muscle More, there is a possibility of subsequent transfer under the muscle
Third method: What is the Dual Plane technique?
In some cases, surgeons use a combined technique called Dual Plane, in which the upper part of the prosthesis is placed under the muscle and the lower part is placed under the breast tissue.
This method is very useful in cases such as slight sagging of the breast or the need to fill the lower part of the breast, and creates a kind of balance between the advantages of the two main methods.
effect of prosthesis on mammography and breastfeeding
- Mammography: Prostheses on the muscle may interfere with breast imaging, while prostheses under the muscle provide a better view for follow-up examinations.
- Breastfeeding: In general, the placement of the prosthesis does not have a direct effect on breastfeeding. If the operation is done correctly and with suitable cuts, the lactating tissues will be preserved.
using technology in decision-making
Nowadays, by using 3D simulators (3D imaging), the surgeon can show the patient the final form of the breast after the operation with different locations of the prosthesis placement.
This technology helps to make more accurate decisions, reduce worries and increase final satisfaction.
Read more: The effect of augmented reality on cosmetic surgeries
Who are the candidates for each method?
Individual conditions Suggested method Skinny with thin breast tissue Under the muscle or Dual Plane Sufficient fat tissue and little sagging On the muscle Falling Mild breast Dual Plane or under the muscle Professional athlete On the muscle History of capsular contracture Under the muscle Intention of pregnancy or breastfeeding in the future Both methods are suitable, depending on the surgical technique
choosing the type of suitable prosthesis at different ages
The age of the patient is one of the key factors in choosing the best type of prosthesis and its location. With age, there are changes in breast tissue, skin elasticity, fat content, and even lifestyle, which directly affect the result of the procedure. In the following, we will examine the suggestions of breast prosthesis surgery in different age groups:
20-30 age group: beauty and fitness
Features:
- Hard and elastic skin
- Low or medium breast tissue
- Probability of high physical activity or desire for professional sports
Recommendations:
- Silicone or saline prosthesis (if approved by the FDA, depending on individual conditions)
- Placement under the muscle or Dual Plane for a more natural result
- choose a medium size to match the body and prevent premature sagging
- Attention to the future: pregnancy or weight change
30-40-year-old age group: beauty + changes after pregnancy
Features:
- Possibility of breast size change after pregnancy or breastfeeding
- Possibility of slight sagging
- desire to restore the natural shape of the breast
Recommendations:
- The Dual Plane technique is very effective (half of the prosthesis under the muscle, the other half under the breast tissue)
- In case of obvious sagging, the combination of prosthesis with lift (Prosthesis size Medium to larger with a natural or medium (not too prominent) profile
- Silicone prosthesis, for more natural touch and form
Age group 40 to 50 years: rejuvenation, form recovery
Features:
- Decreasing skin elasticity
- Breast sagging, reduced tissue volume
- The importance of maintaining a natural appearance and lasting results
Recommendations:
- Silicone prosthesis with natural profile
- in most cases need to combine with breast lift
- Placement of the prosthesis under the muscle or Dual Plane for a softer appearance and prevent the edges from being visible
- Priority with natural results, not large sizes
👩 🦳 Age group 50 years and above: safe and natural beauty
Features:
- More fatty tissue, sagging skin
- Higher sensitivity to side effects
- Possibility of underlying diseases (heart, diabetes, thyroid...)
Recommendations:
- If the general health conditions are suitable, it is possible to do prosthesis
- Using lighter prostheses (Lightweight Implants) or smaller sizes to avoid pressure on the tissue
- Placement under the muscle for better coverage
- In most cases, combination with lift is recommended
- Full health check-up is mandatory before the operation
Important points in choosing prosthesis according to age:
- Age is only one of the criteria; Breast tissue, skin quality, beauty goals and lifestyle have a more decisive role.
- At any age, careful consultation with a specialist surgeon is the most important step.
- If pregnancy or severe weight loss is predicted in the future, this should be considered in choosing the size and location of the prosthesis.
