Is breast implant removal under muscle harder?

Hi
I can't give a specific recommendation without more information, photos and an exam.
The technique of explantation will depend on the status of the implants (intact vs not; infected vs not) and whether you have a capsular contracture that also needs to be addressed. Generally a inframammary incision will give he best exposure for explantation and capsulectomy. Even if the muscle is cut it typically will scar back down after explantation.
Recovery will depend on whether the capsule also needed excision which makes it a longer procedure with a drain likely needed - even with that the recovery shouldn't be too bad.
I hope this he;ps .....

A 20 years old implant is an old implant.Few issues need to be clarified The condition of the implants, are they intact?what is the condition of a 20 years old capsule, are they calcified, with calcium deposits?How much of the muscle was released in the original surgery? The muscle, if released enough during the original surgery is now probably at the level of the areola attached to the breast tissue. If left without re-attachment to the chest wall (Normal anatomy) it will cause animation of the breast after explant.If the capsule is to be removed, then an inframammary incision is needed. Enblock explant needs an inframammary incision.Before surgery a mammogram and an MRI might be needed