Positions of the implant relative to the breast.

Beneath the breast and beneath the muscle.

The positon of the implant is most commonly under the upper portion of the pectoral muscle.  This approach is especially useful for the use of saline implants.  Saline implants have a tendency to produce rippling or a wavy pattern of folds or hills and valleys on the skin.  When the implant is placed under the muscle this adds another layer of tissue to camoflage the upper portion of the implant.  In addition, the beneath the muscle postion ordinarily results in a softer implant with less capsule formation.

Completed Augmentation

"Capsule Formation"

A capsule is the reaction the body produces to the foreign body of the implant.  This reaction occurs with all types of materials which are not a part of the body.  An example is cardiac pacemakers.  This reaction is similar to scar tissue.  When it is thin it results in a soft breast reconstruction.  When it is thick it produces firmness of the breast.  This reaction is uncommon, but can be distressing for the woman with the firmness.  There is little in the way of treatment other than re-operation.  I advise patients that this is one of the most important considerations for a woman who is considering breast enlargment with implants.