An implant placement between the breast and the chest muscle is called a sub glandular placement and a breast implant placed behind the chest muscle is called a sub muscular placement. With sub glandular placement the surgery and recovery time is shorter and less painful, but there is more risk of the implant hardening and deforming (capsular contracture) and it can cause difficulties with mammography imaging. The sub muscular placement tends to be more uncomfortable and the recovery time longer but achieves a more natural breast appearance and decreases the risk of problems with mammography.
There are three main types of incisions commonly used to insert breast implants, and these should be discussed with the surgeon beforehand:
1) The Periareolar incision is made around the nipple and leaves minimal scarring but potentially causes breastfeeding difficulties.
2) An Inframammory incision is the most popular incision because it doesn’t cause problems with breastfeeding or leave bad scars. Small cuts are made underneath each breast to insert the breast implant.
3) The Axillary incision is made in the armpit area around the side of the breast and will leave more of a visible scar than the other incisions, but doesn’t cause difficulties with breastfeeding.
The operation is carried out either under general or local anaesthetic (sometimes as day surgery, but usually with an overnight stay in hospital) and the procedure takes around an hour. An incision (surgical cut) is made in or near the breast and the surgeon will create a pocket for the breast implant to lie in, either beneath the muscle or beneath the breast tissue (size and shape will determine the outcome of the position of the implant and the patient should discuss this with their surgeon).
Following surgery dissolvable stitches will need to be removed and a sports bra worn 24 hours a day for up to three months. The breasts will be firm and swollen at first and will take several weeks to settle into a natural position but the sports bra can help the patient to feel more comfortable.
