Choosing the best breast implant type and pocket location for each patient involves careful planning. Dr. Andrade takes accurate measurements and assesses the patient’s skin tone for optimal results. He will then discuss the different implant types, pockets, and incision locations with patients so they understand the benefits and risks of each. As a guide for patients who are interested in breast augmentation surgery, we have prepared a summary of the pros and cons of the different implant types, pocket locations, and incision locations. Each patient is unique and surgical knowledge is always changing. This is meant as a general guide to supplement an in-person appointment with the surgeon.

IMPLANT TYPE

PROS

CONS

Silicone gel

  • “Breast like feel” of the implant
  • Cohesive gels retain upper fullness
  • Won’t deflate
  • More durable than saline
  • Typically less rippling
  • More expensive than saline
  • Silent rupture
  • Must be 22 or older for warranty (age 20 saline)
  • Likely higher risk capsular contracture

Saline

  • Smaller incision
  • Less expensive
  • Rupture is obvious
  • Likely lower risk of capsular contracture
  • Possibly more visible rippling on thin tissue
  • Might feel less natural to some patients
  • Breast deflates if implant ruptures
  • Slightly higher rupture rates than silicone

IMPLANT POCKET

PROS

CONS

Subpectoral/ Submuscular

  • Less rippling due to muscle coverage
  • Natural look and feel
  • Smoother transition from chest wall
  • Visible implant animation with
  • Some patients report longer recovery, more painful
  • Possible effect on chest muscle, strength (uncommon)

Subfascial

  • Possibly quicker recovery than subpectoral
  • Possibly more upper fullness
  • Increased risk of bleeding compared to subglandular
  • Few long term studies showing actual benefit

Dual Plane

  • More upper coverage/lower risk of rippling
  • Natural look and feel
  • Good option for patients with minor sagging
  • Fills out lower pole to create “teardrop” look
  • Possibly lower capsular contracture rate
  • Helps correct minor sagging w/out a lift
  • Implant may take longer to settle compared with subglandular/subfascial
  • More dissection, visible animation when exercising
  • Requires greater surgeon expertise
  • Possibly higher risk bleeding
  • Risks of bottoming out compared with sub pectoral
  • “Window shading”
  • Might notice pec muscle move differently

Subglandular

  • Might have slightly less painful recovery
  • Implants do not move/shift with exercise
  • Final results usually achieved sooner
  • May have rounder, more “augmented” results
  • Possibly higher risk of capsular contracture
  • Increased risk of rippling in patients with little tissue
  • Implants more palpable compared with sub pectoral

INCISION TYPES

PROS

CONS

IMF Incision (under breast fold)

  • Excellent control of bleeding
  • Precise creation of pocket under direct vision
  • Incision usually well hidden under breast
  • Possibly lower rates of capsular contracture
  • Original incision can be reused if another surgery
  • Lower risk of disturbing ducts (breastfeeding) or affecting areola sensation
  • Visible implant animation with
  • Some patients report longer recovery, more painful
  • Possible effect on chest muscle, strength (uncommon)

Transaxillary (under armpit)

  • No visible scar on breast
  • Option for women wanting to breastfeed
  • Possibly visible scar under arm
  • More difficult to control bleeding
  • Drains might be needed
  • More difficult to create precise pocket
  • Higher rates of malposition
  • Not a good option for dual plane
  • More difficult to do revisions through same incision

Periareolar (around the nipple)

  • Good proximity to breast, control of bleeding
  • Natural colouring of areola can hide scar
  • Incision can be used for revision surgery
  • Risks of ripple/loss sensitivity
  • Scar more noticeable with poor scar forming patients
  • Possible higher risk capsular contracture
  • Might affect breast feeding in future

In conclusion, there are many things to consider before making a final decision about proceeding with breast augmentation surgery. An experienced plastic surgeon will be able to provide good advice to best meet the patient’s goals as well as minimize risks of complications. Dr. Andrade is the sole owner of The York Plastic Surgery Centre and has been in practice since 2005. He has one of the busiest breast augmentation practices in the region according to our implant supplier.

To speak with a cosmetic surgery coordinator or book a consultation, call 905-898-2519.

IMPLANT TYPE

PROS

  • “Breast like feel” of the implant
  • Cohesive gels retain upper fullness
  • Won’t deflate
  • More durable than saline
  • Typically less rippling

CONS

  • More expensive than saline
  • Silent rupture
  • Must be 22 or older for warranty (age 20 saline)
  • Likely higher risk capsular contracture

PROS

  • Smaller incision
  • Less expensive
  • Rupture is obvious
  • Likely lower risk of capsular contracture

CONS

  • Possibly more visible rippling on thin tissue
  • Might feel less natural to some patients
  • Breast deflates if implant ruptures
  • Slightly higher rupture rates than silicone

IMPLANT POCKET

PROS

  • Less rippling due to muscle coverage
  • Natural look and feel
  • Smoother transition from chest wall

CONS

  • Visible implant animation with
  • Some patients report longer recovery, more painful
  • Possible effect on chest muscle, strength (uncommon)

PROS

  • Possibly quicker recovery than subpectoral
  • Possibly more upper fullness

CONS

  • Increased risk of bleeding compared to subglandular
  • Few long term studies showing actual benefit

PROS

  • More upper coverage/lower risk of rippling
  • Natural look and feel
  • Good option for patients with minor sagging
  • Fills out lower pole to create “teardrop” look
  • Possibly lower capsular contracture rate
  • Helps correct minor sagging w/out a lift

CONS

  • Implant may take longer to settle compared with subglandular/subfascial
  • More dissection, visible animation when exercising
  • Requires greater surgeon expertise
  • Possibly higher risk bleeding
  • Risks of bottoming out compared with sub pectoral
  • “Window shading”
  • Might notice pec muscle move differently

PROS

  • Might have slightly less painful recovery
  • Implants do not move/shift with exercise
  • Final results usually achieved sooner
  • May have rounder, more “augmented” results

CONS

  • Possibly higher risk of capsular contracture
  • Increased risk of rippling in patients with little tissue
  • Implants more palpable compared with sub pectoral

INCISION TYPES

PROS

  • Excellent control of bleeding
  • Precise creation of pocket under direct vision
  • Incision usually well hidden under breast
  • Possibly lower rates of capsular contracture
  • Original incision can be reused if another surgery
  • Lower risk of disturbing ducts (breastfeeding) or affecting areola sensation

CONS

  • Visible implant animation with
  • Some patients report longer recovery, more painful
  • Possible effect on chest muscle, strength (uncommon)

PROS

  • No visible scar on breast
  • Option for women wanting to breastfeed

CONS

  • Possibly visible scar under arm
  • More difficult to control bleeding
  • Drains might be needed
  • More difficult to create precise pocket
  • Higher rates of malposition
  • Not a good option for dual plane

PROS

  • Good proximity to breast, control of bleeding
  • Natural colouring of areola can hide scar
  • Incision can be used for revision surgery

CONS

  • Risks of ripple/loss sensitivity
  • Scar more noticeable with poor scar forming patients
  • Possible higher risk capsular contracture
  • Might affect breast feeding in future

In conclusion, there are many things to consider before making a final decision about proceeding with breast augmentation surgery. An experienced plastic surgeon will be able to provide good advice to best meet the patient’s goals as well as minimize risks of complications. Dr. Andrade is the sole owner of The York Plastic Surgery Centre and has been in practice since 2005. He has one of the busiest breast augmentation practices in the region according to our implant supplier.

To speak with a cosmetic surgery coordinator or book a consultation, call 905-898-2519.

MODERN PRIVATE SURGICAL FACILITY
"Yorkville of the North"™

Conveniently located off highway 404 in Newmarket Ontario, The York Plastic Surgery Centre is a cosmetic surgical to facility that meets CPSO regulatory standards of safety, technology and patient care. Dr. Andrade is a trusted member of the healthcare community. Also, all of the medical staff that work at the facility include board certified anaesthesiologists and fully credentialed OR nurses.

Operations performed at the facility are done on an out-patient basis with in home nursing care as needed. Patients requiring more complex surgeries stay overnight at the hospital.

The entire staff  at The York Plastic Surgery Centre work hard to make every patient feel welcome, comfortable and well informed.

Disclaimer: Images and videos on this page are models.  See Dr. Andrade's photo gallery for hundreds of actual patient outcomes.  It is not possible to guarantee a specific result because outcomes vary from patient to patient.

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Dr. Andrade is a distinguished inductee with RealSelf’s Hall of Fame as a top 100 & 500 contributor. This award signifies outstanding patient ratings and a commitment to patient education.
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