Installation of implants under the pectoral muscle: pros and cons

Surgeries to increase breast size have become very popular in the last few years. This is explained by a combination of psychological, physiological and aesthetic reasons. Despite the fact that women go to the doctor for different reasons, each one must undergo an examination. The surgeon’s task is to correctly consider the type, shape and size of the implant. The latter is installed in 2 ways - directly under the breast tissue or partially under the pectoral muscle. The final choice depends on the results of the preliminary examination of the patient.

There are several ways to install implants

The most common option is installation under the breast tissue. The operation does not entail an increased risk of complications. The likelihood of muscle injury is minimal. Another advantage is that the operation itself is speeded up, so the recovery period takes less time. Such benefits are suitable for ladies who have sufficient thickness of the skin and the mammary gland itself. This is necessary so that the upper part of the implant is not noticeable after the completion of the surgical intervention. The second option involves installation under the pectoralis major muscle. In this case, according to surgeons, the most natural result in all respects is achieved.

The positive aspects of this method include the fact that it is possible to achieve uniform coverage of the upper part of the slope. At the same time, the risk of contracture formation is reduced. Even if it is necessary to do a mammogram in the future, the patient will not have any problems. Each of the described methods has positive and negative sides. These should be discussed with your doctor. Before visiting the office of a man in a white coat, you need to do a little preparatory work. The patient finds several detailed photographs showing the desired breast shape. This will allow the doctor to quickly understand what is going on.

Breast augmentation in Russia

In Russia and Eastern Europe, patients ask for the volume to be reasonable, so that it looks quite natural, the breast size should fit the figure. And in this case, installation under the gland will not be suitable; it will be necessary to place it under the muscle so that the implant is not visualized and the breast has the most natural shape possible.

There is also the opinion of patients, and even doctors, that installing implants under the muscle does not give anything at all. Because by installing an implant under the muscle, the surgeon damages the muscle: when an incision is made into the pectoralis major muscle, for example, from below, the muscle goes upward, i.e. rises to a fairly large distance. Thus, muscle function is lost, or at least impaired.

Criteria for choosing the optimal option

Implantation under the pectoral muscle should not harm the patient’s health. The second criterion is that the breasts must have a natural appearance. The last point often causes misunderstandings. In fact, the process of installing an implant under the pectoral muscle is prescribed in the medical literature. The criteria on the basis of which it is legitimate to draw a conclusion about the success of the operation are also indicated there:

• the breast has a soft gentle slope towards the nipple;
• most of the actual volume is concentrated in the lower part;
• the point where the nipple is located protrudes the most;
• upon visual examination, it is noticeable that the chest is localized at the level of the middle of the shoulder;

The size of the implants is selected in such a way that it emphasizes the natural beauty of the existing breast, and does not create something new. For these purposes, several preliminary consultations are carried out, during which the surgeon discusses the details of the future operation:

• implant volume – you must choose an option that corresponds to the width of the chest;
• the implant must match the elasticity of the skin and glandular tissue;
• the implant should look proportional to other parts of the body;
• the most common type of implant is the teardrop shape, which gives the breast a natural appearance;

After the operation is completed, the breasts are slightly higher than the lady is used to. There's no need to worry. Within 2-3 months, the breast level will return to normal.

Price in Moscow

How much does breast augmentation cost? Your doctor will tell you the exact amount during your consultation, after assessing the scope of the operation.

Advantages of placing an implant under the pectoral muscle

From a physiological point of view, this option is more attractive. It is neatly hidden under the muscle and breast tissue itself. Anyone who does not know about the fact of the operation will never guess about it. From the outside it will seem that the fair sex has been generously rewarded by nature. If we talk about other advantages, they look like this:

• quick and less painful period after surgical recovery;
• more voluminous breast appearance – push-up effect;
• ease of mammography examination;
• the edge of the implant is not visible at the upper and inner border;
• the likelihood of breast sagging is reduced to almost zero.

After completion of the operation, the likelihood of developing capsular contracture is minimal.

Ideal breast parameters

Despite the fact that beauty is a subjective concept, researchers from the world of aesthetics have managed to establish parameters that can be taken as the ideal beauty of a woman’s bust!

The basis was taken as the arithmetic mean of the results of measurements taken among 18-year-old girls with a height of 164 cm.

• The weight of one mammary gland is about 400 g
• Areola diameter – 3-4 cm
• Nipple diameter 6-8 mm
• Nipple height – 3-4 mm
• The distance between the two mammary glands is 3-4 cm
• Distance from nipple to navel – 24-25 cm

Beautiful and large breasts are not always synonymous, as many people think. The most important thing in the attractiveness of a bust is that it matches the proportions of the body.

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Choosing the optimal breast implant profile

The profile of the implants is how far they rise above the chest. When taking this parameter into account, the doctor looks for a middle ground. On the one hand, the breasts should remain natural, and, on the other, become expressive. Here you need to start from the actual width of the chest. The width of the implant base should be slightly less than the width of the lady’s chest. Increased caution should be exercised when it comes to miniature patients with a fairly narrow chest. In this case, the surgeon makes the following decision. The size of the implants is selected so that they are slightly smaller than the woman’s breasts. With this development of events, there will be no problems associated with a lack of tissue to cover the implants. Continuing the theme of size, you need to dwell on a significant detail. The doctor takes into account the patient’s weight, height and volume. By comparing the data, a person makes a conclusion about the required size of the implant. The second factor, taking into account which helps reduce the risk of side effects, is related to the woman’s lifestyle. Luka athletes should avoid being too curvy. The doctor’s task at the preliminary examination stage is to eliminate the likelihood of complications. Individual intolerance, increased sensitivity, a number of chronic and hereditary diseases - all of these are factors that make it impossible to carry out such an operation. It is important to note here that each case is unique. Only after a detailed study of the collected information does the surgeon make a final conclusion. If a positive decision is made, the patient is subject to hospitalization. After all manipulations are completed, the rehabilitation stage begins. Throughout its entire length, the lady is under the control of the doctor.

You can learn more about this operation from the “Breast Augmentation” section.

Are implants safe?

Surgery is considered fairly safe. However, recently the media has been shaking the information space about the safety of silicone products. I urge you to treat any news soberly, focusing not only on flashy headlines, but also on objective facts. Women with already installed endoprostheses and those who are just planning to do so are afraid of the risk of developing cancer.

Assessing the relationship between endoprostheses and cancer, it is obvious that implant-associated lymphoma is an extremely rare disease. In total, less than 1% of cases have been registered in which women, some time after endoprosthetics, encountered complications in the form of a disease. There are many more factors that cause malignant tissue degeneration than wearing medical silicone products: genetics, ecology, lifestyle, stress level, solar radiation, etc. Augmentation using endoprostheses has proven to be the most effective and safest method.

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What to Expect During the Tissue Expansion Process

During your second or third visit to the doctor, you will have your first tissue expansion done.

• If you had a procedure where the speculum was placed under the muscle, the nurse will use a small needle to inject a normal saline solution into the tissue speculum through its port.
• If you had a procedure where the speculum was placed over the pectoral muscle, the nurse will remove the air from the tissue speculum and fill it with normal saline.

Tissue expansion procedures are prescribed every week or every two weeks. The tissue expansion procedure itself takes only a few minutes. After each enlargement, the operated breast will enlarge, but it will not reach its final shape until the permanent implant is placed. After each expansion, you may feel stiffness and fullness in the breast and discomfort in the shoulders and back. This usually goes away within a few days.

How to Increase Your Comfort Between Tissue Expansion Treatments

After expansion, you may feel pain in the chest area as if after a workout. There are several ways to feel more comfortable between tissue expansion procedures:

• Take warm showers several times a day to help your muscles relax.
• Take over-the-counter pain relievers (those you can buy without a prescription), such as acetaminophen (Tylenol®) or ibuprofen (Advil®).
• Apply fragrance-free moisturizers (such as Eucerin® or Lubriderm®) to your breast skin. Do not apply moisturizers directly to the incision site for 6 weeks after surgery or until the scabs fall off.

• Do the shoulder stretches and other exercises listed in the Exercise After Mastectomy resource your nurse gives you. You may find it easier to stretch after showering because your muscles will be more relaxed.
• Wear soft, supportive bras. Avoid wearing bras with underwire (wire frames).

Daily routine

After the tissue expansion procedure, you can return to your normal activities. During your recovery period, follow these guidelines to ensure your safety and comfort.

• Within a few hours after the procedure, you can return to work and simple household chores.
• For 6 weeks after surgery, you should not lift anything heavier than 5 pounds (2.3 kg) with your operated side. Pets and children are also prohibited. Ask your breast surgeon how many lymph nodes were removed during the operation. Limitations on lifting heavy objects may depend on this.

Sports activities

• Avoid strenuous exercise for 4 to 6 weeks after surgery or until your doctor tells you to do so. For example, you cannot engage in various types of running or jumping.
• Avoid exercises that strain or pump up your chest muscles. Talk to your healthcare provider about when you can start doing this type of exercise again.

car driving.

• You can drive once your shoulder on the operated side has full range of motion and you have stopped taking prescription pain medications.
• If you are traveling long distances in your car and the seat belt is directly on the fabric extender, place a soft pad underneath it. Buckling up in a car is very important, so always wear your seat belt.

Tips for choosing clothes

The tissue expander may be slightly larger than the target size. If you have had surgery on one breast, by the end of the expansion process the operated breast may appear larger than the other.

At different stages of breast reconstruction, you can use bra filler to maintain body symmetry. One of these fillers can be a soft breast pad. The cover is a lightweight nylon pouch. Its size can be adjusted to match the size of the other breast by adding or subtracting cotton fluff from the pouch. This helps a lot when the mammary gland becomes larger during expansion.

The breast shield can be purchased from the Breast Boutique at the Evelyn H. Lauder Breast and Imaging Center. Breast Boutique is located at 300 East 66th Street at the intersection with Second Avenue. For more information, call 646-888-5330.

You can put soft gauze in your bra, which you can get from your nurse. Change the gauze pad every day to keep it clean.

It is also recommended to wear:

• loose blouses, tops and sweaters;
• dark knitted tops under a loose blouse, sweater or jacket;
• tops with diagonal stripes or asymmetrical prints;
• neckerchief or shawl;
• shift dresses with buttons;
• robes.

to come back to the beginning

About the procedure for reconstruction of the nipple and areola

Some patients also require nipple reconstruction to recreate the nipple and areola. Options for reconstruction of the nipple and isola:

• 3D tattoo of the nipple and areola . During this procedure, a physician's assistant will recreate the nipple and isola through tattooing. The tattoo will not recreate the volume of the nipple, but the color and texture will match the natural nipple. For more information, read the material Information about the procedure for tattooing in the area of ​​the nipple and areola.
• Skin flap for transplantation . During this procedure, reconstruction of the nipple and isola is performed using a skin graft. For a skin flap graft, tissue is taken from one part of your body (donor site) and transferred to the surgical area that needs to be covered (recipient site). For more information, read the material Reconstruction of the nipple and isola with skin grafting.
• A combination of these 2 procedures.

If you decide to have nipple reconstruction, you will have to wait about 2-4 months after receiving a permanent breast implant.

to come back to the beginning