Breast Augmentation in Houston: Understanding Breast Implant Pocket Placement

Breast augmentation is one of the most requested cosmetic surgery procedures in Houston, helping women enhance breast size, shape, and overall balance. While choosing the right implant type (saline vs. silicone) and size is important, one of the most critical decisions in achieving long-lasting, natural results is the placement of the breast implant pocket.

The implant pocket refers to the space where your breast implant is positioned — either above, below, or partially beneath the chest muscle. This choice directly affects the appearance, feel, recovery, and long-term outcome of your breast augmentation.

Why Implant Placement Matters

The location of your implant influences:

• Breast Shape & Cleavage – whether your results look soft, natural, or more projected.

• Risk of Complications – including capsular contracture, implant visibility, or rippling.

• Long-Term Breast Health – effects on mammography, aging, and skin stretching.

• Recovery Time – pain levels and activity restrictions vary by pocket type.

Over time, the effects of pregnancy, weight changes, and aging can alter breast tissue, making your initial implant placement decision critical for long-term satisfaction.

Different Breast Implant Pocket Options

1. Subglandular Placement (Over the Muscle)

In this technique, the implant is placed directly beneath the breast gland and above the chest muscle.

✅ Best For:

• Patients with adequate natural breast tissue for coverage.

• Women with mild breast sagging (ptosis).

• Athletes and bodybuilders who want to avoid muscle interference.

✅ Advantages:

• Faster, less painful recovery.

• Natural cleavage appearance.

• Ability to place larger implants.

• No implant distortion from chest muscle contraction.

⚠️ Disadvantages:

• Higher risk of capsular contracture (~25%).

• Greater risk of implant rippling or visibility in thin patients.

• Narrower cleavage.

• Less soft-tissue support as breasts age.

2. Partial Submuscular Placement (Under the Muscle)

Here, the implant is placed beneath the pectoralis major muscle but not fully under all chest wall muscles.

✅ Advantages:

• Lower incidence of capsular contracture (~13%).

• Less rippling and implant palpability.

• Improved mammogram imaging.

⚠️ Disadvantages:

• Longer recovery and more post-operative discomfort.

• Risk of “breast animation deformity” (implant movement with muscle flex).

• Possible “double bubble” deformity if tissue droops.

3. Dual-Plane Breast Augmentation

The dual-plane technique combines benefits of both subglandular and submuscular placement. The upper implant is covered by muscle, while the lower implant sits beneath breast tissue.

✅ Advantages:

• Softer, more natural slope of the upper breast.

• Less implant palpability.

• Reduced rippling.

• Less chance of implants riding too high.

• Decreased risk of lateral implant displacement.

• Capsular contracture risk similar to submuscular (~13%).

⚠️ Considerations:

• Muscle contraction may still affect implant shape slightly.

4. Total Submuscular Placement (Complete Under the Muscle)

This less common option places the implant fully beneath the pectoralis and serratus muscles.

✅ Advantages:

• Maximum implant coverage.

• Further reduction of visible rippling.

⚠️ Considerations:

• More invasive.

• Not suitable for all body types.

• Limited implant size options.

Factors That Influence the Right Choice

The “best” implant pocket varies by individual. Dr. De La Cruz carefully evaluates:

• Breast Tissue Thickness – to ensure proper coverage and natural feel.

• Degree of Ptosis (Sagging) – whether a lift is also recommended.

• Lifestyle – athletes, weightlifters, or highly active patients may need specific placements.

• Desired Look – softer natural look vs. more upper pole fullness.

• Implant Type & Size – silicone vs. saline, smooth vs. textured, and size selection.

• Long-Term Maintenance – how the breasts will age and whether future surgeries are likely.

Risks & Considerations Across All Techniques

Every breast augmentation carries general surgical risks, but specific to implant placement:

• Capsular Contracture – scar tissue tightening around the implant.

• Rippling/Palpability – more likely with saline or thin tissue coverage.

• Implant Malposition – riding high, bottoming out, or lateral shift.

• Breast Animation Deformity – more likely in submuscular placements.

These risks are minimized when the procedure is performed by a board-certified plastic surgeon with extensive breast surgery experience.

Why Choose Dr. Emmanuel De La Cruz for Breast Augmentation in Houston

Dr. De La Cruz is a double board-certified plastic surgeon recognized for his expertise in breast augmentation, revision breast surgery, and body contouring. At De La Cruz Plastic Surgery in Houston, patients benefit from:

• Customized breast augmentation plans tailored to anatomy and goals.

• Expertise in advanced placement techniques, including dual-plane augmentation.

• Accredited surgical facility for safety and comfort.

• Natural, beautiful results designed to last.

FAQs About Breast Augmentation in Houston

Q: Which implant placement looks the most natural?
A: The dual-plane technique often produces the most natural appearance by blending the benefits of submuscular coverage with subglandular fullness.

Q: Will implants affect breastfeeding or mammograms?
A: Placement under the muscle generally makes mammograms easier to read. Most patients can still breastfeed, but this should be discussed individually.

Q: What if I develop sagging later in life?
A: Depending on tissue changes, a breast lift (mastopexy) may be combined with implant revision for optimal results.

Schedule Your Breast Augmentation Consultation in Houston

Choosing the right implant placement is one of the most important decisions in your breast augmentation journey. To explore your options and receive a customized surgical plan, schedule a consultation with Dr. Emmanuel De La Cruz, one of Houston’s most trusted and experienced breast augmentation surgeons.

📞 Call (832) 776-1134 or request your appointment online.

Learn More Or Schedule A Consultation!

Contact Us Today! Call (832)776-1134

NO TOUCH TECHNIQUE

Dr. De La Cruz employs the "no-touch-technique" breast implant placement.  He utilizes the Keller funnel to introduce the breast implant into the retropectoral pocket.  Employing this technique have several advantages.  These advantages are:

• Reduces the risk of infection

• Reduces contamination of the the breast implant

• Potentially reduces the risk of capsular contracture

• Reduces the stress of the outer shell of the breast implant since there's less manipulation of the implant during placement. Thus, there's a possible reduction of the risk of implant rupture.

• Smaller incision

INCISION SIZE

Dr. De La Cruz makes a very small incision when he performs the dual-plane breast augmentation.  The incision ranges from  2.5 cm to 3.0 cm.  There are several advantages of having a smaller incision:

• Smaller scar

• The smaller incision, the lesser risk of infection

• Lesser risk of implant extrusion (lower chance of the "implant coming out of the wound.")

• Lesser post-operative pain and thus, faster recovery

FASTER RECOVERY & MINIMAL DOWNTIME

• The downtime after your breast augmentation with Dr. De La Cruz is very minimal. For example, if your surgery is done on a Thursday or Friday, you can potentially go back to work the following Monday.

• Due to the very small incision (2.5 cm to 3.0 cm) that Dr. De La Cruz uses for your breast augmentation, the post-operative pain is very minimal. Thus, there's less usage of narcotic pain medications.

FOLLOW UP

• Your follow up appointments are included in your breast augmentation package.

• Dr. De La Cruz will follow your post-operative results very closely. The typical follow up appointments include 1 day after surgery, 1-2 weeks after surgery, 2 -4 weeks after surgery, 2-3 months after surgery, 6 months to 1 year after surgery, and yearly thereafter or as needed.