Breast Augmentation: Subglandular Technique

Breast augmentation is one of the most common procedures that women undergo on a yearly basis. Women seek to undergo breast augmentation surgery for a variety of reasons. Once the decision has been made by the patient to undergo this elective procedure, the next steps are to speak with a Chicago Plastic Surgeon so that the appropriate surgical plan can be developed. Each case is unique and must be consulted based on the individual patient’s case.

There are two major techniques that Plastic Surgeons use when performing this type of surgery. Those procedures include: submuscular and subglandular. The goal of this article is to discuss the subglandular procedure technique; and to describe the associated risks and benefits.

Procedure

The subglandular technique is used when the implant is placed under the glandular tissue of the breast, above the muscle layer. A pocket is created above the muscular layer, using anatomic landmarks as the borders of the pocket. Once the pocket is created, then the implant is inserted under the highest sterile conditions. The two main types of incisions used are inframammary (under the breast, in the crease) and peri-areolar (around the bottom of the rim of the areola). The procedure is associated with less pain than the submuscular technique.

Benefits

There are a few benefits to the subglandular technique over the submuscular. In some patients who have sagging in the breasts, placing a larger implant in the subglandular plain can help to give them a small lift. This can delay having to place additional incisions in order to lift the breast. Patients who already have a moderate amount of breast tissue can have subglandular breast implant placement without it looking unnatural. This is less often the case for skinnier patients, who will look more “fake” if they get a subglandular implant. The other benefit is that the procedure is generally associated with less pain than submuscular placement.

Risks

As with all surgeries, there are risks associated with the subglandular breast augmentation procedure. One of the major unwanted negative outcomes that can be associated with the subglandular placement of breast implants is capsular contracture. Capsular contracture occurs when fibrous tissue builds up around the implant. The breast implant becomes contracted and the result is a firm and possibly distorted breast. Capsular contracture is one of the major reasons that women undergo breast revision surgery. Visible rippling of the implant is more common with subglandular placement and the main reason why it is not done as often in skinnier patients. Infection and bleeding are risks associated with any surgery. Antibiotics and strict sterile technique is used to minimize infections. Although post-operative bleeding can happen, it is rare to have to return to the OR to fix it. It is imperative for both the patient and the physician to evaluate the risks associated with this particular technique, to determine how to proceed with the surgical procedure.

Next Steps

Breast augmentation surgery can have a dramatic effect and patients are very happy with their decisions. Speak with your healthcare provider to determine the most appropriate breast implant surgical technique. Each case is unique, and must evaluated as such.