I am having a double mastectomy with nipple sparing reconstruction. My plastic surgeon is recommending subglandular implants however it seems like submuscular are more often the recommendation . I am looking for some further advice on this.
Thanks for your question. Both methods are safe. Above the muscle implants after mastectomy are becoming more and more popular as the safety of this has improved as well as the techniques.
90+% of reconstructions I perform are above the muscle ( prepectoral) majority of of my patients have very little pain, and the aesthetic results are in my opinion much better.
In addition you don’t get what’s called the animation deformity that is seen for under the muscle reconstructions.
Best of luck with your reconstruction following mastectomy
Truly the submuscular is better.
Decades ago, we learned that submuscular is better for cosmetic augmentation becasue it places a thick pad of well-vascularized tissue (muscle) over most of the implant. This factor is even more important in breast reconstruction, where there is very little of the woman's own tissue-basically skin and a variable thickness of subcutaneous fat-to cover a prepectoral implant. A layer of acellular dermis is frequently placed over prepectoral implants to povide another layer. I would avoid this. Also, you don't ask about the type of implant-gel or saline. I have always preferred saline. It is true that if the implant is under the muscle, contraction of the muscle can produce transient distortion, the so-called "animation deformity." In 40 years I never had a woman complain about this. Some even thought it was cute, and it excited their companions.
There are two ways to do it. Your surgeons are going to recommend what they think is best and you have the option to consult another plastic surgeon.