What is a subfascial breast augmentation? | Dr. Emily Kirby
Sub-Fascial Breast Implant Placement (Preservation Breast Augmentation)
Preservation breast augmentation involves placing implants subfascially, or over the chest muscle, but under a thin fascia muscle layer, preserving the natural pectoralis muscle and its attachments. Before modern, cohesive silicone implants were available, submuscular placement (under the pectoralis chest muscle) was the best approach to hide visible implant rippling from saline implants and to help preserve a natural look and feel. Over-the-muscle placement “subglandular” implant position has historically led to a higher risk of capsular contracture.
Studies have now shown that subfascial placement has a safety profile similar to submuscular placement, reducing the risk of capsular contracture compared to subglandular placement. Although submuscular placement effectively conceals most of the implant, it requires a longer recovery, and the implant shape can be affected when chest muscles are activated, leading to “animation” of the implant with movement of the chest muscles. Many patients are now considering over-the-muscle (but under the fascia, “subfascial”) breast implant placement.
Video transcript
When we place an implant in the chest, historically, we used to position it under the pectoralis muscle for safety reasons. More recently, we’ve returned to an older technique—placing the implant above the muscle—but with a refined approach. Instead of simply going above the muscle, we place the implant in a special plane under the fascia of the muscle. This is not the same as subglandular placement, where the implant sits directly above the muscle. Instead, it’s called subfascial placement, meaning the implant is positioned beneath the fascia. In this plane of augmentation, we get the benefits of both approaches. We maintain the safety profile of placing the implant under the muscle while avoiding distortion of the breast implant caused by muscle movement.
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