So the quest continues, to make the mysteries of boob jobs and breast augmentation a bit less mysterious for all. We've addressed a few common questions (Saline vs silicone? Round vs anatomic?) and started in on the technicalities of this surgery - time now to wrap up Breast Aug 101.
Last week's Friday Figure Fix focused on the types of incisions available for placing breast implants. Now, let's delve a layer or two deeper and investigate where exactly those implants go.
It's fairly self-explanatory, right? Breast implants go in the area of the breast. But where, exactly? As plastic surgeons, we like to place implants in a well-protected area - more layers of defense against the outside world and a little padding to help camouflage the man-made construct. The luxury of extra coverage is not always available (like in breast reconstruction for breast cancer survivors, which is another topic entirely in itself), so we like to take advantage of that good tissue in breast augmentation surgery.
In the academic journals, some plastic surgeons like to split hairs when they describe the location/technique for breast implants (you'll occasionally run across terms like "subfascial" or "dual-plane"), but when discussing the future home for your breast implants, it pretty much boils down to two locations, as seen in my illustration above.
1. Submuscular (or subpectoral). Here we're talking about placing the breast implant underneath the chest muscle - the pectoralis major, specifically. Why do that? Again, the muscle provides another hearty layer of protection between the implant and all the bugs that roam about the outside world. Some people believe that the extra muscle layer helps blunt the slope of the breast, to give a "more natural" and "less implant-y" look.
There have also been some studies that show a decreased incidence of capsular contracture (hard and sometimes painful scarring around the implant) when breast implants are placed beneath the muscle. There is also speculation that breast function (e.g. sensation, breast feeding potential) is disturbed less with this technique, since there is less surgical manipulation of the breast tissue.
2. Subglandular. If you have enough breast tissue or subcutaneous fat to disguise the implant, subglandular placement (putting the breast implant underneath the breast - which is the gland we're talking about) is an option. Some folks prefer this placement because it looks "more natural" (Isn't that what we said about technique #1? Go figure.). Recovery time tends to be a little quicker, since you're not really messing with the muscle - much less soreness and crampy muscle pain.
So that's pretty much the ins and outs of the technical aspects of breast augmentation - all the key decision points you should hit in the consultation with your plastic surgeon. But wait, you say - all we did so far was gloss over the rosy bits of boob jobs - let's be realistic here - can't things go wrong?
Glad you asked. We'll discuss what can go wrong with breast implants/boob jobs/breast augmentation on the next installation of the Friday Figure Fix!
