Positioning of Implants
Implants can be placed above or below the pectoralis (chest) muscle. 98% of the time, Dr. Schlesinger prefers going below the pectoralis muscle because:
A) It gives an extra layer of covering over the implant, therefore making the implant less obvious.
B) It is common knowledge in plastic surgery that implants under the muscle tend to stay softer over time.
C) The pectoralis muscle originates on the humerus (bone of the upper arm) and inserts on the clavicle (collar bone) and the sternum, therefore, with the implant underneath the pectoralis muscle, the breast appears to originate in an unbroken line from the collarbone to the nipple, whereas if you go on top the muscle, the breast implant appears to start much lower, giving it a less natural look.
D) Mammography of the breast is made easier if the implant is behind the muscle because the radiologist sees the muscle density and knows that all the breast tissue is above this muscle density and the implant is below.
Like most plastic surgeons in the U.S., Dr. Schlesinger goes partially subpectoral, cutting a small strip of pectoralis muscle off the fifth rib. He feels if the implant is completely subpectoral, this does not give a natural, or teardrop shape to the breast.