How painful is healing from submuscular implant placement v. sub glandular?

Question

Hi. I'm a fit 60 yr. young female, 5' 4", 120#, Cauc. I realize pain varies & am struggling re placement. I'm aware of pros & cons of each & lean toward subpectoral as better since I want saline (maybe chambered Ideal brand) & don't want rippling. But, recovery from incised muscle seems Rough. 1. How long does worst part of pain recovery last w/ submuscular? 2. Is incising muscle ok? I bodybuild, not competitive. 3. Is sagging less w/ submuscular? Thanks!

Anna Steve, MD · Answer

Recovery from breast augmentation is fairly rapid, regardless of whether you choose to have the implants placed above or below the muscle. A long acting numbing medication placed at the time of surgery combined with gentle dissection during surgery makes pain manageable with just Tylenol and Advil during the recovery period in most cases. Body builders are a subgroup that may want to consider a sub glandular placement the implants rather than sub muscular.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Women tell me the first 3 days are uncomfortable when placed sub muscular , similar to when their milk came in during pregnancy for those with children. Medication is used at this time. It eases up a great deal by the 4th day and 90% of my patients are back to work, in an office setting, by the 5th day. I have several competitive bodybuilders, with sub muscular, and they start their workouts by the 6th week post op. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear Compassionate8587,
with a good preoperative examination, surgical technique and postoperative protocol, the pain level can be significantly reduced. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Submuscular placement gives better coverage, better upper breast fullness, and less long term sagging because the weight of the implant is partially supported. However, you do see muscle flexion and it is more painful initially, like when you were engorged with milk, and takes longer to settle.  You will feel lots of pressure initially.

James Hoyt, MD (retired) · Answer

The pain experienced during the healing process after breast augmentation can vary from person to person, and it's influenced by factors such as individual pain tolerance, surgical technique, and the specific placement of the implants. Both submuscular (under the chest muscle) and subglandular (over the chest muscle) implant placements come with their own set of considerations regarding pain and recovery.Submuscular Placement:1. Initial Discomfort: Submuscular placement typically involves more initial discomfort because the plastic surgeon creates a pocket beneath the chest muscle, which may cause more muscle-related pain.2. Muscle Spasms: Some individuals may experience muscle spasms or tightness as the muscle adjusts to the presence of the implant. This can contribute to discomfort in the first few days to weeks post-surgery.3. Movement Limitation: Patients may experience temporary limitations in arm movement and lifting, as the muscle needs time to heal and adjust to the implants.4. Longer Recovery: The recovery period for submuscular placement might be slightly longer compared to subglandular placement.Subglandular Placement:1. Less Muscle Disruption: Subglandular placement involves positioning the implants above the chest muscle, resulting in less disruption to the muscle.2. Less Initial Muscle Pain: Patients often experience less initial muscle-related pain compared to submuscular placement.3. Shorter Recovery: The recovery period may be somewhat shorter for subglandular placement, and patients may regain normal range of motion and activities more quickly.Individual Variability:It's crucial to recognize that pain perception is highly individual, and some people may find the recovery from submuscular placement less painful than anticipated, while others may have a smoother recovery with subglandular placement. Surgeons often prescribe pain medication to manage discomfort during the initial postoperative period.Additionally, advancements in surgical techniques and pain management protocols can contribute to minimizing discomfort during recovery. Patients should follow their plastic surgeon's postoperative instructions carefully, including taking prescribed medications and attending follow-up appointments.Before undergoing breast augmentation, it's essential to discuss your preferences and concerns with your plastic surgeon. They can provide recommendations based on your anatomy, lifestyle, and goals, helping you make an informed decision about implant placement that aligns with your needs.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!It is true that there is more discomfort following submuscular placement of a breast implant as opening another plane of dissection does involve additional trauma. However, patients undergoing a later implant repositioning from subglandular to submuscular do not report a significant difference in subjective pain. Recovery time is not affected (up and about within a week). Submuscular implant placement has been shown to result in less capsular contractures and less rippling.The pectoralis muscle is not cut during the procedure. The inferior border of the muscle is identified visually and a plane of upward submuscular dissection is carried out. The pectoralis muscle covers the superior portion of the implant only and will not affect sagging. A large implant, however, may create a degree of sag.P.S.: age is not a number! If you are healthy, you are still young...Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...

How painful is healing from submuscular implant placement v. sub glandular?

Answers (6)

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