Is breast implant removal under muscle harder?

Assuming that your implant hasn't ruptured and you're not experiencing a complication such as capsular contracture, your recovery really should not be bad. You will be sore but the fact that your implant is below the muscle will not prolong your recovery in any way. Best of luck.

If your implants are intact and you are not having any current complications the recovery should not be too bad.  You can expect some soreness.  Wearing a supportive garment after will help.  Your surgeon will be able to give you more specifics based on your situation.

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

Generally, breast implant removal surgery is a very well-tolerated procedure;  recovery is not longer because the breast implants are in the sub muscular position. Also generally speaking, the pectorals muscle does not need to be "reattached". Best wishes for an outcome that you will be very pleased with.

You don't need them removed through a submammary incision if you are not having a capsulectomy.  I have taken those implants back out through the incision in the armpit.

In the vast majority of cases, the muscle is not cut during explant surgery.  Therefore, there is no reason to expect reattachment surgery.  Wear a good compression bra while healing to assist in recovery.