The space into which a breast implant is inserted is called the implant pocket. In all breast augmentation techniques an implant, filled with either saline or silicone, is placed behind or on top of the chest muscle (pectoralis major muscle).
Placement of the breast implant under the chest muscle generally produces a more natural look and feel. The additional thickness provided by the muscle coverage of the breast implant reduces the chances of developing visible rippling in the upper aspect of the breast and blunts the more obvious, rounded, “augmented” appearance of the upper aspect of the breast. Under the muscle placement also allows for better visualization of breast tissue with mammograms when compared to breast implant placement on top of the muscle.
Occasional issues with under the muscle placement that may lead some patients to choose placement of the implant on top of the muscle. Post-operative pain is one such issue. Another known concern is animation deformity, the elimination of implant movement with vigorous pectoralis muscle contraction. For most patients it is mild and easily accepted. In more severe cases the problem is corrected by performing a pocket switch procedure. This procedure moves the breast implant from an under the muscle pocket to a new pocket on top of the muscle.
The placement of the incision for the implant is another aspect that differs among the breast augmentation techniques. Incisions can be made along the breast fold, in the belly button, within the armpit or along the lower border of the areola.