Is It Always Necessary To Place Breast Implants Under the Chest Muscle? 

Woman in bra with arms wrapped around body (model)

Dr. Mark Jewell and Dr. Alireza Najafian answer this question in terms of what they call their version of the modern breast augmentation. This answer is based on their many years of performing breast augmentations, scientific research, and knowledge of how to produce a great long-term outcome with high levels of patient satisfaction. 

Historically, there was a focus on placing breast implants behind the chest muscle for all patients as a way to achieve a lower rate of capsular contracture and to disguise the rippling of saline implants. Unfortunately, this was a more painful recovery after surgery.

When Subfascial Breast Augmentation Is Preferred

Data from newer studies demonstrate that an excellent outcome can be achieved by placing breast implants in front of the chest muscle but behind the muscle fascia (sub-fascial location). Moreover, the sub-fascial location prevents the annoying animation deformity where the breasts tighten when the chest muscles are tightened.

They have also found that patients with sub-fascial breast implant placement avoid what is termed the “waterfall deformity,” where the breast tissue falls off the implant mound when it is held behind the chest muscle. In their experience, if the breast implant is in the same location as the breast, patients will avoid these problems. 

Factors That Determine Implant Placement

Both Dr. Jewell and Najafian believe that implant location must be determined by taking tissue measurements at the time of the breast augmentation consultation and listening to each patient describe their level of physical activity.

Tissue-based decisions for implant locations allow patients to achieve the most natural-looking outcome and best recovery. Implant location is determined by the amount of upper breast tissue that is measured with calipers (pinch test). Typically, if a patient has 30 millimeters (1¼ inches) of tissue or more, she has enough to have a smooth upper breast with the implant in the subfascial location. 

Choosing an Experienced Breast Surgeon

Dr. Jewell is a world leader in breast augmentation with regards to the process for breast augmentation, infection control, and clinical research. The modern breast augmentation can produce beautiful outcomes and avoid issues associated with submuscular implants. His published outcome data is the best in the world—zero infections following breast augmentation surgery in over 45½ years of clinical experience. 

To learn more about breast implant placement and your breast augmentation options, request a consultation with Dr. Jewell or Dr. Najafian using our online form. Or call our office in Eugene, OR, at (541) 683-3234 to schedule an appointment directly.

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