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Subfascial Breast Augmentation

Since the initial use of breast implants, plastic surgeons have been seeking the proper plane into which the implant might be placed. The original site behind the gland (subglandular) resulted in implant edge visibility, especially in thin women, and was thought to result in a higher incidence of fibrous capsular contractures than the later subpectoral plane (under the muscle). Despite the advantage of concealing the implant border, some surgeons thought that implant distortion (implant animation) occurred with contraction of the muscle. Then in 2004, a Brazilian surgeon – Dr. Ruth Graf – developed a procedure that placed the implant under a protective covering that allowed the benefits of subglandular and subpectoral positioning, without their disadvantages. This was introduced as the Subfascial Breast Augmentation.

In order to understand why this technique is superior in the selected patient, we must first introduce the anatomy (see Figure 1). Every muscle is encased in a thin, but durable, layer of connective tissue – and the pectoralis major muscle is no exception. This 1mm – 2mm layer of tissue, known as fascia, has extremely high tensile strength. This is why muscles develop in a predictable form, regardless of whether they grow or shrink.


By placing the implant directly under this layer of fascia, there are obvious benefits:
The breast implant is covered by a durable tissue layer, reducing implant visibility.
There is no need to transect (or cut) the pectoralis major muscle, leading to less pain and discomfort, as well as less downtime.
There is no “implant animation”(distortion of the implant with activity), as the pectoralis major muscle is left intact.
There is no need to wait for the implants to “drop” as in the submuscular technique.
Because there is no splitting of the pectoralis muscle, patients can return to the gym and exercise earlier.

What our patients have to say about us:

Thank you for rejuvenating me after the lowest and hardest point in my life ( my struggle with cancer). You guys are truly angels from above. God Bless you both!!
Many heads turned at the gym yesterday as i ran on the tread mill. My size medium under shirt accentuates my new form. It felt good that attractive guys and girls our age and younger were noticing me. You're the best!

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