While submuscular placement is the preferred approach, this is more painful than the subglandular alternative. The manipulation and release of the muscle can be a source of discomfort (although blocks and long-acting local have been effective in reducing post-op pain).

That being said, recovery, regardless of approach is typically 7-10 days. Patients are encouraged to avoid exercise for a month and heavy lifting or very strenuous activity for 6 weeks.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

In most cases, subglandular (above muscle) placement is the least painful. I would caution you to not make your decision about implant placement based on post-surgical discomfort. Above muscle placement is the least performed by plastic surgeons because of the increased risk of issues such as capsular contracture, visible rippling or folding of the implant, breast sag, etc.

Published on Jul 11, 2012

Above the muscle is the least painful breast implant placement option because the musculature is not manipulated as with under the muscle. That said, by week 2, there probably is no difference in pain between above and below the muscle.

Published on Jul 11, 2012

Subglandular is certainly less painful than submuscular/dual plane placement, but has a significantly higher risk of capsular contracture.

As for the incisions, I think they are all fairly equivalent. You can argue the periareolar area is more sensitive than the inframammary fold, and therefore may have stranger post-op sensations. The main source of discomfort after breast augmentation is overwhelmingly the muscle lifting, so the actual incision site is usually not very painful.

Published on Jul 11, 2012

A suprapectoral implant placement is the least uncomfortable procedure.

Michael Eisemann M.D.
Plastic Surgeon





































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































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Suprapectoral placement is least uncomfortable









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Published on Jul 11, 2012

Thank you for your question! The least painful implant placement is going to be the Dual Plane technique with the insertion of the implant through the Inframammary crease. This will give you the quickest recovery, with the least amount of complications. More literature on the techniques and various ways of insertion can be found on the American Board of Plastic Surgery website-->https://www.abplasticsurgery.org/

Published on Jul 11, 2012

It is not the incision placement that dictates pain/recovery. For that they are all the same. Going dual- plane or full submuscular is more painful to start out with, but provides better results long term so they are worth the added discomfort in the short term. I hope this helps.

Published on Jul 11, 2012

Sub glandular (on top of the muscle) is less painful, but shows more wrinkling.

Published on Jul 11, 2012

They are all about the same but under the muscle or sub muscular placement is definitely more painful than on top of the muscle.

Published on Jul 11, 2012

Thank you for the question. There is less "discomfort" with sub-glandular placement of breast implants.

There are pros and cons to the placement of breast implants in the “sub muscular” position versus the "sub glandular position”.

I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position. This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).

The submuscular positioning also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.

On the other hand, sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle) they can be seen with breast implants placed in these sub muscular position.
I hope this helps

Published on Jul 11, 2012

You should expect some soreness and discomfort after a breast augmentation, regardless of which placement option you choose. For most patients, the discomfort is easily managed with pain medication and icing the chest area. Many patients experience discomfort for 2 to 3 days after surgery, and then experience soreness for the next week or so.

Published on Jul 11, 2012