Implant Pocket Selection

When a breast augmentation is performed, a pocket is created for the breast implant.  The pocket can either be made under the breast itself (sub-mammary), or under both the breast and chest muscle (sub-pectoral).

·        SUB-MAMMARY POCKET:

In the sub-mammary approach, the implant is placed between the breast tissue and the chest muscle.

This position is often recommended for women who already have a fair amount of breast tissue, and who may also have a mild degree of breast droopiness.  Having a moderate amount of breast tissue will help to conceal a sub-mammary implant.  As well, mild amounts of breast droopiness will be corrected.

Sub-mammary placement is also recommended for unusually shaped breasts since the implants will help to change the shape of the breast better than sub-muscular implants.  Finally, professional, competitive body builders are usually better off with implants placed above the chest muscle.

·        SUB-PECTORAL POCKET:

In the sub-pectoral approach, the implant is placed under both the breast and chest muscle.  The chest muscle covers the upper 2/3 of the implant, while the bottom 1/3 is covered by your natural breast tissue.  This helps to provide a natural, tear-drop shape to the breast.

In general, sub-pectoral placement is more common than sub-glandular.  The sub-pectoral approach is recommended for women who have minimal amounts of breast tissue.  Since the chest muscle covers the implant, it will act like extra padding, making the implant less ‘feel-able’ and ‘see-able’.  Other advantages include a lower risk of capsular contracture (hardening of the breasts), and making mammograms easier to read (for example, in a woman with a family history of breast cancer).

There is no single approach that is ideal for every patient.  At the time of your consultation, Dr. Edelstein will help you to decide which option for implant pocket placement is best for you, keeping in mind your personal goals and expectations.