Breast Implants – in front of the muscle

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

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

Today I’’m going to be talking to you about the different stages in a sub-glandular breast implant. This is an operation where you place the implant in front, rather than behind the muscle.

In a recent operation, I used this technique because the lady had sufficient natural breast tissue to allow enough thickness of breast coverage over the implant.

The first stage was to mark the incision and double check my markings.  In this case, I’ lowered the inframammary fold slightly so the incision would lie in the fold.

The next stage was to put some local anaesthetic in the incision, which involved infiltrating the cavity under the breast tissue with a weakened solution of local anaesthetic.

The next stage was really just to go through the skin. I like to divide this using electrocautery as this coagulates any blood vessels on the way in, so there is no bleeding.

Next I created the cavity above the muscle, checking that everything’ was absolutely free inside. I inserted a temporary inflatable implant and inflated it with a syringe. This gave me really fine control of the size of the implant. Once I had a very good filling of the breast cavity, I removed the implant.

Next stage was to clean everything out by irrigating the cavity with some sterile saline solution, just to remove any bacteria and make sure everything was as clean as possible. I then inserted some antibiotic, Gentamicin, to further reduce the risk of infection.

I then cleaned the skin again with iodine, which is antiseptic, and changed my gloves.

The implant was then inserted  under the breast tissue. I cleaned everything up, checked everything fit and the implant was nice and soft, before sewing up the wound in three layers.

I used absorbable stitches which don’t need to be removed, but the ends do need trimming at a week following the surgery.

I placed some glue over the incision, which allowed the patient to wash from an early period because it seals the wound from any potential bacteria.  Finally, I placed some brown tape on the incision, and dressed the lady in a surgical bra.

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