Breast augmentation... Which approach is less painful with quicker recovery?

Silicone gel implants do not appear to have any aesthetic distinction above or below the pectoralis muscle. Because of that I preferentially placed them in a sub glandular position where the convalescence is significantly easier for the patient.

Hi Eileen,Yes you can expect a quick recovery. The main concerns aren't the incision or the pocket placement, but what maneuvers are done during the procedure and how fast you start your postop exercises.  It is like a marathoner.  The worst thing a marathoner can do is to lie down and rest at the finish.  You would be the same, where by you would want to keep moving, keep loose and do your stretching exercises. Much has been published on the quick recovery approach in recent years in our journals. A recent study followed over 2,800 BA patients for this recovery program showing over 90% returned to normal daily activities within 24 hours.  Some even went out the evening of their surgery.  If you want to look at the web reference below, you can see this recovery method outlines.  The website below also has videos showing patients with various incisions demonstrating this program postoperatively.  All the best in your upcoming procedure and recovery, "Dr. Joe"

The first couple of days after the breast augmentation are the most uncomfortable but most patients by day 2-3 are getting off their pain medication and being a little more active.  If your job is a sedentary job without too much lifting you should be able to get back to it after 4 days but you will still be a little sore and tired.I find that a nerve block during surgery along the ribs helps with post op pain and allows patients to be more active faster.  I find the inframammary incision a lot quicker recovery than around the areolar and axillary approach.  Under the muscle does have more pressure sensation but is still preferable for a better result than above the muscle in most cases.Best of luck with your upcoming surgery.

Going above the muscle has less risks for you but you are giving up the advantages of submuscular when you do this.  When going above the muscle, you have to consider using shaped implants to diminish the risks for contractures but they don't move.

If you are only comparing under breast (infra-mammary fold) and under arm (axillary) then the answer is very simple, infra mammary will be the less painful and will have a quicker recovery. Also i dont agree on getting active immediately, i usually recommend my patients the complete opposite, Elbows should be stick to your body for at least to weeks, about going back to work, if you where my patient, and your job doesn't required to lift your arms i wouldn't have any problem, but this is not the most common case.  Talk to your Plastic Surgeon and follow his instructions.Best of Luck,Dr. Luis Redondo

Hello, Thanks for your question. Theoretically, a sub glandular plane should be considerably less painful than a submuscular plane, because the muscle must be partially freed for the submuscular inclusion, and it is highly innervated. Also, an Inframammary incision should result less painful than a periareolar one, because even though temporary loss of sensation happens in both, the end points of the scar still have sensation and the areola is much more sensitive than normal skin. Now, to be honest with you, with the right pain meds, you shouldn't feel lots of pain. More like soreness, but no pain.Hope this answers your question. Any other doubt, feel free to contact me. Take good care of yourself, Dr. Fernandez Goico

I do not believe that location of incision determine speed of recovery.  However Sub-glandular breast augmentation is typically less painful with quicker recovery than when the implants are placed beneath the muscle.