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How do subpectoral and subglandular implants differ?

Erik A. Hoy, MD
Plastic Surgery

The terms subpectoral and subglandular refer to the positioning of the breast implants within your body. "Subpectoral" denotes an implant pocket that is positioned in a plane beneath, or deep to, the pectoral muscle of the chest. These implants are less apparent from the outside of the body, as the margin of the implant is draped in muscle. Some studies suggest that this positioning lessens capsular contracture and rippling of the tissues around the implant.

"Subglandular" describes an implant pocket position that is beneath or deep to the glands of the breast, but superficial to the pectoral muscle. Implants in this position are more apparent, as their margins are more easily visualized. Capsular contracture rates and rippling may be increased with this position. Some patients prefer this more visible implant, and prefer the upper pole fullness (sometimes referred to as cleavage) from the more visible implant. Many surgeons suggest that this upper pole fullness is not a natural appearance of the breast, and if patients desire this look, they should achieve the effect with a pushup brassiere.

Stuart A. Linder, MD
Plastic Surgery
Subpectoral implants and subglandular implants are associated with the positioning of the implants either above versus below the muscle. Majority of patients who have minimal breast tissue in my practice will undergo the dual plane technique with implants placed in the subpectoral pocket. That means that the implant is placed behind the pectoralis major muscle along the anterior two thirds of the implant with the lateral third of the implant placed subglandular. There is no muscle to cover the lateral third of the implant.

The serratus anterior muscle is a deep muscle directly interdigitating into the ribcage along the chest wall. This should not be used for cosmetic elective augmentation mammoplasty procedure. It may, however, be used for reconstruction after breast cancer mastectomy surgery. Subglandular procedures were the most common approach to breast enhancement surgery back in the 60s, 70s and 80s. The implants were placed above the pectoralis major muscle. 

The risks of subglandular placement include increased visibility, rippling, palpability, and increased capsular contracture and scar tissue formation. As a result, from the early 90s on, mostly the subpectoral dual plane technique has been used to reduce encapsulation, reduce visibility, give a more natural upper pull slope to the implant, and to make it easier for mammography and radiologists to detect breast cancers.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.