Breast Implants – behind the muscle

Thinking about Breast Enlargement surgery? Below, Aurora Plastic Surgeon Adrian Richards talks about a recent operation where he positioned the implants behind the muscle.

Hello, my name’’s Adrian Richards. I’’m a Plastic Surgeon and the Surgical Director of Aurora Clinics.

Today I’ll be taking you through each stage of a procedure which I recently performed on a lady, inserting a teardrop shaped implant in a dual-plane position and that’’s partially behind the muscle.

I’ used this approach in this lady because she’ was very slim without sufficient breast tissue to cover the implant if I placed it in front of the muscle.  So the muscle acted as another layer in front of the implant.

First, I marked the patient up and put local anaesthetic mixture where I’ would be making the incision. This numbs everything up and gives very good pain relief, about 12 hours following the surgery.

I created a tunnel and inserted the local anaesthetic and adrenaline mixture under the breast gland.  This has the joint benefit of reducing any bleeding and also giving very good pain relief.

I made the incision, a five centimetre incision in the inframammary fold. Sometimes I do need to lower the inframammary fold if there isn’’t one already in situ. With my forceps, I’ held the muscle up, and inserted the sizer implant, a temporary implant just to check that the pocket size was okay and everything looked good.

Next I irrigated to wash out the cavity, just to make sure there were no small amounts of tissue in there. I used antibiotics inside and then Betadine on the skin, an antiseptic to reduce the risk of any infection.

I put new gloves on before touching the implant so it was as uncontaminated as possible. I put the implant gently into the pocket, and double checked it was in the correct orientation.

The closure was very similar to other types of implant – a three layer closure with absorbable stitches just to give the wound good support. I used absorbable stitches that need no removal, and finally put some Dermabond glue on, which is tissue glue, just to seal the wound.

I hope you found this account interesting and informative. For any more information about breast augmentation, please feel free to contact the team on 01324 578290 or email