Subfascial Breast Augmentation: When and Why? Above Muscle Technique, NC*

This 37-year-old mother of 2 children lost what little volume her breast had after childbearing and was unhappy with her small breast size wishing to go from a 34A up to a C cup. She also was very athletic and was into lifting weights and doing some body building. She was concerned about the options in breast augmentation particularly about animation deformity. Animation deformity occurs when submuscular breast implants are performed and the action of the pectoral muscle causes the implants to move upwards and sometimes outwards. Placement on top of the muscle is often recommended in women who are trying to avoid this issue. The pros and cons of under the muscle versus on top of the muscle must be discussed during the initial consultation with your plastic surgeon. Submuscular placement remains the most common technique for many reasons. However, when the on top of muscle technique is chosen, many plastic surgeons are now using a specific technique which is called subfascial where the implant is placed on top of the muscle and under a thin layer of fascia that envelops the muscle. The rationale is a potential for reduced capsular contracture, less step-off deformity in the upper pole and potential for less visible rippling. This patient shows a silicone gel breast implant. She had some asymmetry, so she had a an Allergan SSF 365 cc implant on the right side and an Allergan SSF 345 cc implant on the larger left breast. Sizing was assisted with Crisilix 3D imaging.