Subfascial placement is a new type of procedure whose popularity has increased in recent years with the widespread use of endoscopy. Implants are placed in the subfascial layer under the mammary gland tissue but on top of the pectoralis major muscle. The fascia is very thin in this area, only approximately 1–2 mm. Complete dissection in this plane would be very difficult to achieve without the aid of endoscopy; thus, the precision and complexity of this procedure are much higher than those of subpectoral surgery. It is a more advanced method of breast augmentation. The advantages of subfascial placement are that no crucial blood vessels or nerves are involved and that there is less damage to the muscle or tissue compared with that in the case of subpectoral placement. Thus, the recovery period is shorter, and there is much lesser pain after surgery. It is a modern and user-friendly breast augmentation procedure complying with human physiological characteristics and is ideal for patients afraid of pain.
Transaxillary, periareolar, or inframammary incisions can be used for subfascial placement. Implants are placed in the subfascial layer under the mammary gland tissue and on top of the pectoralis major muscle, a position that is closer to real breast tissue. This method not only allows the faster setting of shape but also can more easily create a natural teardrop shape or draping. In addition, the procedure does not require any cutting or damaging of muscle tissues and thus results in very little pain after the procedure or during massage. The postoperative care period can be shortened to 3–6 months. This surgery prevents implants from being affected by muscle contraction. Therefore, there are no restrictions on lifting weights or exercising with arms after surgery. On average, normal bras can be worn in 3 months, and no unusual movement of the breast due to muscle contraction is observed. However, this procedure is limited by conditions of the breast and skin. Patients must have thick enough breast tissue to cover implants to achieve a natural look and touch; otherwise, implant edges or ripples can be noticeable by touch because of the shallow placement. In addition, implant size should be moderated to avoid extra burden on the skin, which could result in premature breast sagging or unnaturally round breasts.