The submuscular position is also known as subpectoral or under the muscle placement. Dr. Brown always prefers this pocket choice for most patients who undergo augmentation mastopexy surgery. The implants are generally placed in the submuscular pocket, and the breast tissue is elevated and tightened over the new breast mound.
This pocket is advantageous as it hides and covers the implant so it is less perceptible. With more natural soft tissue coverage over the implant, the implant remains hidden, looks more natural, and feels softer. There are fewer risks for rippling (implant perceptibility) and capsular contractures (scar tissue build up) in this location. It is necessary in patients with excessive thinness or lack of breast tissue, as the muscle covers and supports the implant. Skin alone is not adequate for implant coverage in thin-chested women, as visible rippling detracts from an attractive aesthetic result. In addition, in any situation of minor wound healing issues, the implant remains well protected under the muscle.
The over-the-muscle pocket, also called subglandular or subfascial, may be used in select cases.