Breast Augmentation Surgery placing the Implants behind the Muscle

Video of Breast Augmentation Surgery with placement of silicone implants behind the muscle performed by Mr. Adrian Richards specialist plastic surgeon with a wide experience in performing breast enlargement procedures at Aurora clinics in Buckinghamshire. For more information or should you wish to schedule a FREE consultation with our specialist surgeon, call 01844 214362.

Breast Augmentation Surgery

Placing the Implants Behind the Muscle

Hello, my name is Adrian Richards. I’m a plastic and cosmetic surgeon and the Surgical Director of Aurora Clinics based here in the United Kingdom. In this very short video, I’m going to be taking you through an operation and it’s a breast enlargement operation and I put the implants behind the muscle in this case. I’ll discuss the reasons for this in the video.

So here’s our patient just before the operation. You can see she’s relatively small busted, probably an A cup and the distance between her nipple and the fold is quite short at 5 centimetres, and I’m going to elongate that in her breast augmentation surgery by lowering the fold.

So this is the appearance at the beginning of the operation. You can see the markings here. This line coming down here is the level of the muscle. So the pectoralis muscle will lie in this area here. That’s the lower aspect which I’m going to release. This hatch line here is where I’m going to divide the muscle so that it lies nicely above the implant, because if it’s tight here, it will tend to push the implant up. So if there is any tightness here, it tends to push the implant up, which gives a double bubble effect and I want the implant to sit nice and low. So I’m going to release here.

This is the old inframammary fold here on both sides. So the old fold was about 5 centimetres from the nipple, and that needs to be lower. I’m going to make it 7 centimetres here. So I’m going to lower the fold, release the fold from inside there. So overall the plan is going to be to make the incision here, lower the fold, release inside there, go under the muscle so it will be in front of the muscle in this position, behind the muscle in this position, release the muscle here to the level of the fourth rib or the level of the nipple.

So here I’m just making the incision, which is 4.5 centimetres in length, and this is below the old fold. So this is the old fold here, and I’m lowering it, so I’m making a 4.5 centimetre incision here below the old fold. The yellow tissue here is the fatty tissue.

So here I’ve just cut through the skin 4.5 centimetres in length, and the incision is below the old inframammary fold. So this is the old fold here, and I’ve gone 2 centimetres below it, so increasing that from 5 to 7, and this incision is in the new fold.

So can you see this is the muscle? So I could have gone in front of the muscle, but I’ve divided it and gone behind the muscle. You see there behind, and this is the level here. These are the ribs, so we’re on the ribs, with the muscle in front of the implant here. That’s where I’m going to put the implant, behind the muscle.

So here you can see, this is an inflatable breast sizer. It isn’t the actual implant. It’s just a tester, and this is the syringe I’m going to blow it up with. So in a minute I’ll put that implant in.

So this is just the sizer going into the cavity there, and then this is me just blowing up the sizer, there. So I’m just blowing up now till 330, so that’s 330 ccs. That fits nicely. So I think we’ll use a . . .

Take this out and then wash everything out, put some antibiotics in the cavity, and then I’ll put the main . . .

So, in this case, I’m going to use a Nagor 330 cc textured round, medium profile implant, which I’m just going to insert now.

So that’s the implant in place. Now I’m just going to sew this incision up in three layers with absorbable stitches as I’ve shown you in other videos.

Here you can see, that’s the old inframammary fold which has been nicely released.

So here you can see that the old inframammary fold here has been filled out. So you’ve got a nice natural curve to the lower part of the breast. I’ve just sewn up the incision here, and these are just the ends of the absorbable suture here. Actually, I’m just going to apply some tissue glue. This is . . .

This is the implant we’ve used in this case, which you’ll see is a Nagor IMP-MR 330 cc, and it’s a moderate projection as I think you can see that. So that’s the base which is 12 centimetres and the height at 4.3 centimetres.

So here we can see at the end of the operation, this is my marking for the muscle. So that part is going to be under the muscle, really from the nipple up on that oblique line. Then you can see as I move slightly across, you can see the old inframammary fold was about here, and then the new inframammary fold is down here. So you can see how it filled out this lower part quite nicely, giving a much more sort of natural breast shape. So as you can see, under the muscle is really good for people who need that extra coverage there. So this lady only has under 3 centimetres of natural breast tissue, so I need to go under the muscle for the upper part to give more coverage in this area. Then from the side, this area down here is in fact still in front of the muscle.

So you can see here this is just about finished just before we’re going to put the bra on. This is the line where the muscle is, so the muscle covers this area of the nipple and above. So we’ve no danger of rippling here, because we’ve got that extra layer of muscle in this area here. The muscle doesn’t cover the lower area here. Here the implant is in front of the muscle, because the pectoralis muscle only covers the top half. Here where the breast tissue is thicker, the implant lies in front of the muscle, but you can see this really gives us a good correction here of the lower part of the breast. The old inframammary fold lay here and that’s the fold underneath breast. I’ve lowered it right down to here to give a very nice natural appearance to both breasts. So what will happen now is we’ll put brown tape on the incisions.

Here you can see the appearance from the top, which gives a very good natural appearing bust with a 330 cc . . .

Thanks very much for watching the video. If you think you may be interested in breast surgery, breast uplift, breast reduction, or breast enlargement, please watch the rest of our videos, which you’ll be able to see on our website, Aurora-Clinics.co.uk. Also, we’ve got lots more information. We’ve got free CDs which we’ll be happy to send you if you fill out the application form on our website or e-mail us. Really our aim is to give you as much possible information about your potential procedure as possible.

So a big thank you for watching the video, and again thank you to the patient for allowing us to show it.