Understanding the positioning of breast prostheses in relation to the pectoral muscle is key to the success of a breast augmentation surgery. It influences appearance, safety and long-term aesthetic results. The choice of breast prosthesis positioning, whether it be pre-muscular (in front of the muscle) or retro-muscular (behind the muscle), has a direct impact on the final outcome of the operation. So where should the breast prosthesis be placed, in front of or behind the muscle?
Pre-muscular positioning involves placing the implant directly behind the mammary gland, with several advantages and disadvantages.
Positioning retro-muscular involves placing the implant behind the pectoral muscle. This approach also has its advantages and disadvantages.
Like all surgical procedures, breast augmentation with implants carries its own risks. Complications may be general or specific to the positioning chosen.
General complications related to breast augmentation include :
The choice of positioning can influence these risks. For example, pre-muscular positioning can sometimes increase the risk of capsular contracture, compared with retro-muscular positioning where the implants are better protected by the muscle.
To avoid and minimize the complications associated with breast augmentation, it's essential to keep the implant in place, either with bands used to stabilize the implant during the healing period, or by using a specially designed post-operative bra to hold implants in position and reduce movement during the recovery phase. Dr. Djian will advise you on the best method to adopt.
The choice of breast prosthesis positioning must also take into account individual anatomical features and personal preferences.
The amount of existing breast tissue, skin quality and age play a crucial role in the choice of positioning. For example:
Regular sports activities can also lead to the choice of retro-muscular positioning. This minimizes the risks associated with muscle contraction during exercise, ensuring greater implant stability.
Personal expectations play an important role in the decision to position prostheses.
Aesthetic expectations vary from patient to patient. Some women prefer a more natural look, and will therefore more often choose a retro-muscular positioning. Others may prefer a less invasive procedure, and therefore prefer a pre-muscular positioning. In all cases, the opinion of Surgeon Dr. Djian is decisive in the final choice. Don't hesitate to let him know of any constraints you may have.
For patients considering new implants after having already undergone breast augmentation, it's essential to assess how to adapt positioning to suit existing prostheses. Here too, Dr. Djian will help you define the best approach after a thorough consultation.
Technological advances have considerably improved surgical techniques for positioning breast prostheses, enabling more precise, natural-looking results. Two key innovations are 3D imaging and the dual-plane technique.
New technologies such as 3D imaging make it possible to accurately assess the patient's morphology prior to surgery. This helps determine the best positioning to achieve an optimal aesthetic result while minimizing risks.
The dual-plan method combines the advantages of pre-muscular and retro-muscular positions. It provides adequate coverage while maintaining flexibility of muscle movement. This technique is particularly beneficial for patients seeking to combine aesthetics with post-operative comfort.
Comparative studies show that each technique has its own long-term aesthetic results. The choice between breast prosthesis in front of or behind the muscle must therefore take into account not only the immediate results, but also the long-term effects on the figure.
Implant in front of or behind the muscle
It is essential to address the choice of the position of breast implants with care and thought. An in-depth consultation with the Docteur Djian, experienced plastic surgeon in Paris, This will enable you to evaluate all these considerations to ensure you make the right choice. Taking into account not only medical factors, but also personal ones, will guarantee an optimal result, both aesthetically in the medium and long term, and functionally.
Yes, retro-muscular positioning often leads to more post-operative pain because the muscle is lifted to place the prosthesis. This discomfort is temporary and well controlled by painkillers. On the other hand, this technique offers more natural results in slim patients, with a reduced risk of blistering.
Yes, when changing implants, it is possible to modify their positioning according to the evolution of the skin., The technique can be adapted to the patient's specific needs, desired volume or discomfort. Dr. Djian reassesses each case in consultation to adapt the technique to the current anatomy and avoid complications.
Yes, visual rendering is often more natural when the prosthesis is placed behind the muscle, especially if the patient has little breast tissue. In front of the muscle, the result may appear rounder or tighter, particularly when lying down or when the pectoral muscle is contracted.
After weight loss, the skin is often slackened and the breast tissue depleted: positioning is essential. behind the muscle or technical dual plan is then preferred for avoid visible creases and ensure better wear over time. Dr. Djian adapts the strategy to each individual case.
Yes, prostheses placed in front of the muscle are sometimes more prone to descent over time, especially in cases of thin skin or sagging. Retro-muscular placement often offers better support and limits the effects of gravity over several years.
Dr Jérémy Djian is a plastic surgeon based at 5 square Thiers, near the Victor Hugo roundabout, in the 16th arrondissement of Paris.
He trained in Paris and remains attached to the hospital in the prestigious department of Pr Laurent Lantieri.
