Now you’ve probably heard, or read on the internet that you always get a more natural result if the implant goes behind the muscle. This is usually true, but not always true. There are some situations where we really can’t put the implants behind the muscle. A typical example would be a lady who’s had children and breastfed, and has got somewhat droopy breasts.
There are some situations where we would actually need to do a lift, but if I decide that we can get away without doing a lift, I may nevertheless recommend that the implant go in front of the muscle, directly behind the breast tissue.
As you can imagine, post breastfeeding breasts tend to be very mobile. They go a long way up and down, and they can move sideways. They’re kind of loose, and you can well imagine that if we sit an implant on the chest wall, that’s in a fixed position. The breast tissue is going to is still be mobile on that, if the implant is behind the muscle because the implant and the breast tissue are not in direct contact. So in that situation, when you do have a very mobile breast tissue, you might find that the breast tissue hangs off the implant when you’re leaning forward. When you lie back to go to sleep, the breast tissue sloshes to the size of the implant, and so on and so forth.
Even when you’re just standing up normally, the breast tissue can hang off the end of the implant and we actually have a name for that. It’s a terrible name. We call it the Snoopy dog deformity. It’s not good. We find that if we get the implant size, diameter, and overall dimensions correct and put it in front of the muscle because the implant is now in direct contact with breast tissue, it’s going to control the breast tissue much better, and you won’t get those problems.