Breast augmentation is a conceptually simple operation (increase in the size of the breast by inserting a pair of prostheses), whose numerous technical nuances, however, are often overlooked in the explanations provided by the surgeon before the operation, making it difficult, if not impossible, adequately evaluate the consequences of a fundamental choice such as the position in which the prostheses will be implanted cosmetic surgery thailand .

Breast implants can be implanted immediately below the mammary gland, or more deeply below the pectoralis major muscle. Within the limits of these two positions, there are numerous variations, such as under or over fascial, partial or total submuscular positioning or the more complex dual plane technique. This article aims to illustrate the advantages and disadvantages of the two main positions, briefly addressing the more sophisticated technical variants.

With the reference structures for the implantation of the prostheses highlighted. Immediately below the skin is the gland and a variable component of adipose tissue. The gland rests on the muscular plane. When the prostheses are implanted in a subglandular position , the surgeon separates the gland from the muscular plane, creating a space where the prosthesis will lodge. Conversely, when the prostheses are implanted in a submuscular position , the surgeon performs the dissection below of the muscle, creating a pocket for the implant which will therefore be placed more deeply than in the previous case.

As can be understood, there is no perfect positioning suitable for all patients. An expert surgeon is able to adapt the technique to the specific needs of the case, adequately illustrating its advantages and disadvantages. The differences that distinguish the two main placements are summarized in the following tables. It should obviously be kept in mind that the choice is never actually that simple, as all the technical variants must be considered which allow, as in the case of the dual plane, to limit the disadvantages of one positioning and to acquire some of the advantages of the other.

Subglandular placement

ADVANTAGES

Optimal control of the shape of the breast

Absence of changes in the shape of the breast during the contraction of the pectoral muscle

Optimal control of the position of the inframammary fold and its shape

Faster postoperative course compared to submuscular placement.