Posted September 25, 2015
C. B. from Beaver County asks:
When considering breast implants, do I want to have them above or below the muscle?
Dr. A: There is always confusion about where the breast implants should be placed. There is still debate amongst surgeons about which plane is better. In my opinion there is only one place to safely place a breast implant: under the muscle. The most common risk associated with breast augmentation is “capsular contracture.” Simply stated a contracture means the breast can become firm after healing from an augmentation. There is no good explanation as to why this can occur and it affects approximately 10-12% of women undergoing an augmentation. Placing the implant under the muscle can decrease a woman’s risk of developing a contracture to 5%. Another reason is for better breast cancer surveillance. An implant above the muscle will interfere with mammography results more than if the implant is below the muscle. In other words a small, developing cancer can be missed in early detection due to the implant being placed above the muscle. Also there is no difference in aesthetic outcome between the 2 planes. Again in my opinion, there is no good argument for placing the implant above the muscle.