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What is the Difference Between Breast Reconstruction with Implants Under the Muscle or Over the Muscle?

Breast reconstruction is a crucial part of the breast cancer journey for many survivors. One of the key decisions in implant-based reconstruction is whether to place the implants over or under the chest muscle. This article explores the differences between these two approaches, often referred to as OTM (over the muscle) and UTM (under the muscle) implant placement.

Understanding OTM vs UTM Implant Placement

There are two main approaches to implant placement in breast reconstruction:

  1. Over the Muscle (OTM) or Prepectoral: Also known as “over the muscle implants,” this method involves placing the implant on top of the chest muscle, directly under the skin.
  2. Under the Muscle (UTM) or Subpectoral: In this approach, also called “under the muscle implants,” the implant is placed partially or fully beneath the chest muscle.

Each approach has its own set of advantages and considerations, and the choice often depends on individual factors.

OTM Breast Implants: Advantages and Considerations

Advantages of Over the Muscle Implants:

  • Less invasive surgery with quicker recovery time
  • No animation deformity (visible muscle movement when flexing)
  • Often provides a more natural shape and movement
  • May be preferred for active individuals or athletes

Considerations for OTM Implants:

  • May have a higher risk of implant visibility or rippling, especially in thin patients
  • Potentially higher risk of capsular contracture in some cases
  • May require the use of an acellular dermal matrix (ADM) for additional support

UTM Breast Implants: Advantages and Considerations

Advantages of Under the Muscle Implants:

  • Better implant coverage, especially beneficial for thin patients
  • Potentially lower risk of capsular contracture
  • May interfere less with mammography
  • Can provide a more natural slope in the upper pole of the breast

Considerations for UTM Implants:

  • More invasive surgery with longer recovery time
  • Potential for animation deformity
  • May result in a less natural shape in some cases
  • Can cause more postoperative pain due to muscle manipulation

Factors Influencing the Decision Between OTM vs UTM Breast Implants

The choice between over the muscle vs under the muscle breast reconstruction depends on various factors:

  1. Body type and amount of natural tissue
  2. Size and type of implant
  3. History of radiation therapy
  4. Patient’s lifestyle and activity level
  5. Surgeon’s expertise and preference

Recent Trends in Breast Reconstruction: OTM vs UTM

In recent years, there has been a growing trend towards OTM placement, particularly with the advancement of surgical techniques and the use of acellular dermal matrix (ADM) for additional support. This shift is partly due to the potential for more natural-looking results and reduced risk of animation deformity.

However, UTM breast augmentation remains a popular choice, especially for patients with thin tissue coverage or those concerned about implant visibility.

Implant Over or Under Muscle After Mastectomy

For patients undergoing breast reconstruction after mastectomy, the decision between implant over or under muscle placement is particularly important. Factors to consider include:

  1. Amount of remaining breast tissue post-mastectomy
  2. Skin quality and elasticity
  3. Need for radiation therapy
  4. Desired final breast size and shape

Over the Muscle vs Under the Muscle Breast Reconstruction: Which is Right for You?

Deciding between over the muscle and under the muscle breast reconstruction is a highly personalized process. It’s essential to have a thorough discussion with a board-certified plastic surgeon specializing in breast reconstruction to determine the best approach for your individual case.

Key points to discuss with your surgeon:

  1. Your body type and tissue characteristics
  2. Your lifestyle and activity level
  3. Your expectations for the final result
  4. Potential risks and complications of each approach
  5. Recovery time and post-operative care

The Importance of Personalized Care in Breast Reconstruction

There’s no one-size-fits-all approach to breast reconstruction. Each patient’s case is unique, and the decision should be made after careful consideration of all factors. Your surgical team will work with you to determine whether OTM or UTM implant placement is best suited to your individual needs and goals.

Understanding the differences between OTM and UTM implant placement is crucial for making an informed decision about breast reconstruction. Both approaches have their merits, and the best choice depends on your individual circumstances, body type, and reconstruction goals.

At Learn Look Locate, we’re committed to providing comprehensive, up-to-date information to support you through your breast cancer journey. We encourage you to explore our resources and connect with our community for further support and information on breast reconstruction options.

Remember, whether you choose over the muscle or under the muscle implants, the goal is to achieve a result that helps you feel confident and comfortable in your body. Always consult with a qualified plastic surgeon to discuss your options and make the best decision for your unique situation.