Breast Augmentation risks and complications - subglandular and submuscular implant placement at Plastic Surgery Truth.com

The most frequent risk is capsular fibrosis, the thickening and hardening of the connective tissue around the implant. This can be very painful. It occurs when there is stray blood in the implant cavity. This can cause exaggerated scarring. If the cavity is thoroughly rinsed with a saline solution, capsular fibrosis is unlikely. Other risks are stretch lines and circulatory difficulties. Furthermore, oversized implants in a subglandular position can have a visible outline. In the breasts of very thin women inlays filled with saline can crease the skin. With all implants there is a risk of asymmetry. In most cases, the only solution is to re-operate.

subglandular implant placement submuscluar implant placement

Comment by John Di Saia, MD, a board certified plastic surgeon

This image shows the result of a mid-sized implant placed in the Subglandular position. The young lady presented to my office one year after her first breast augmentation operation using saline implants (by another surgeon). As she was displeased following the surgery, she went back to the original surgeon four months following the surgery. He responded by making the implants even larger and leaving them "Over The Muscle." Let us analyze the aesthetic problems here:

The implant's margins are very visible here especially toward the cleavage.

Even though the patient is only one year from surgery, the breast "mound" has already descended objectionably leaving the nipple and areola positioned "too high" on the mound. This is far more commonly seen in subglandular implants as the Pectoralis major muscle (in the Submuscular case) supports the implants to an extent retarding extreme descent.

The cleavage is poorly-developed even though the patient is displeased that the implants are too large. Usually larger implants develop the cleavage better.

The old implants were removed from the subglandular pockets and replaced with smaller saline implants, which were placed beneath the Pectoralis major muscles. A modified breast lift was performed to reposition the nipple and areola correctly on the new breast mound. The patient's breast look more natural and the cleavage is better developed. This was a fair bit of work leaving the patient looking almost as nicely as she would have if a submuscluar placement had been performed at the first operation.