The sub muscular breast augmentation is the most common method that plastic surgeons perform and that patients request (we have previously posted a blog item on this and other methods) It is becoming more obvious now that there may be problems with this surgical approach. Below are my to five reasons why you may decide on an alternative method of breast augmentation.
1. Persistant Crease:
Sub-muscular breast augmentation patients are frequently troubled by a pesky and persistent crease. The breast fold of your old anatomy will ride-up halfway on your new breast and show as a persistent crease. Often the crease deepens when you use your pectorals muscle. This crease shows when your natural ligaments that formed your native breast crease persist. Mild cases may resolve after 6-9 months, more obvious creases need a revision surgery. A better direction or another more modern surgical approach may prevent this from occurring.
2. Worsening Cleavage:
If you have widely spaced breast a sub-muscular dissection can worsen the décolletage. While a too proximal dissection can result in synmastia (unaboob). If you are concerned about cleavage you may want to use another technique (Read about this issue a previous blog-item )
3. Implants too high with slow implant settling:
One of the pesky post-op issues with sub-muscular surgery is the obvious distortion of high riding implants. The released pectorals major retracts superiorly and pulls the new implant upwards to the clavicle. Usually the implants descent to a better position after 6 months with no further improvements at 9 months. The remnants of the muscle frequently distort the overlying skin. (Read this previous blog item on this issue). This is not an issue with sub-fascial breast augmentation.
4. Painful longer recovery:
Recovering from sub-muscular surgery is not easy. You will need strong narcotics and you need to take adequate time off from work (7 to 10 days) You’ll need to be careful with your new breasts as too much activity can tear the newly dissected muscle and result in a distortion. The pec-muscle never regains full power and this may be a hindrance for athletic performance. Most surgeons recommend to delay vigorous exercising for several months.
5. Delayed problem with implants sliding into the armpits.
When above average sized implants are used the lateral breast ligaments may become over-dissected or stretched. The implants will then be pushed by the contracting muscle towards the armpits. This deformity will be obvious after the first year when you are reclined. The implants will sag laterally leaving an unnatural dip adjacent to your breastbone with your breast displaced into your axilla. There are more appropriate surgical solutions to prevent this from happening.
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