In most cases, when I perform breast augmentation, I place the breast implant, whether it is a saline breast implant or a silicone breast implant, behind the chest wall muscle. There are many reasons for this. The first is that the chest wall muscle (pectoralis major), actually serves as camouflage for the breast implant. Some of the visible rippling that can be seen, particularly with saline breast implants, tends to be obscured to some degree with coverage by the pectoralis major muscle. The second reason to put the implant behind the muscle is that it interferes with screening mammography much less. There is good data from the radiology medical literature that demonstrates that placement of breast implants in front of the chest wall muscle can obscure a substantial amount of the breast field on mammogram. The third reason is that traditional data with silicone and saline implants shows that the rate of capsular contracture, or pathologic scar tissue formation, is much higher when the implants are put in front the chest wall muscle as compared to behind it.
There are a few anatomic conditions in which aesthetic outcomes are improved when the implant is placed in front of the chest wall muscle. Careful examination and discussion with my patients are important in these situations to determine what will be best.
If you have any other questions regarding this or breast augmentation in Dallas and Plano, please do not hesitate to contact my office at 214-827-2814.