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Ask Dr. Teitelbaum (California) In this forum, you can ask Santa Monica, California plastic surgeon, Dr. Steven Teitelbaum, questions about breast augmentation and other plastic surgery procedures.


Submuscular or subfascial placement in a thin woman?

Old 12-02-2011, 06:36 PM
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Submuscular or subfascial placement in a thin woman?

Hi Dr. Teitelbaum,

I would really appreciate if you could clarify me something about breast augmentation procedure.

Is it possible to have a lateral displacement, along with movement of the implant with muscle contraction that would make the breast look distorted if the implants are placed under the muscle? Is there a way to avoid this?

Are there more possibilities of having rippling in the subfacial placement?

Which technique would achieve natural results in a thin woman? Im a 5.1 , weight 88lbs and have a BWD of 11cm.

Thank you
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Old 12-19-2011, 04:24 PM
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subfascial

There is almost no reason to ever use the subfascial approach whatsoever. It adds a meaninglessly thin additional tissue over the implant and has never been shown to have any advantage over purely subglandular except in Brazilian studies in which the complication rate for anything other than subfascial was dramatically higher than in any other reported case series.

Patients who are very thin should go behind the muscle, and it is critical that they select and implant that FITS THEM. Such patients should never try on sizers or bags of rice because that does nothing to respect the amount of tissue coverage that they have.

If properly done, there is very little lateral migration.

And there is no fascia out to the sides so being subfascial does nothing to reduce rippling on the sides.

The best pocket location for breast augmentation is usually dual-plane. This method maintains the advantages of subglandular where subglandular has benefits and the advantages of submusuclar where the muscle has advantages. And it reduces the disadvantages of each.
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