Cosmetic Surgery Tips

Breast Augmentation Under Muscle Or Over

Breast augmentation is a common cosmetic surgery procedure with a wide range of results. While some patients may be satisfied with their results, others may experience complications or dissatisfaction. In this article, we will discuss how breast augmentation under muscle can cause pain, and what to do if you are experiencing any post-operative pain.

When it comes to cosmetic surgeries, it’s important to do your research before making any decisions. Breast augmentation under muscle is an excellent option for many women who want increased firmness and fullness in their breasts. However, there are some risks associated with this procedure that should be discussed with your surgeon beforehand.

One of the most common complications associated with breast augmentation under muscle is post-operative pain. This type of pain can occur anywhere from several days after surgery until several months after the operation has been completed; however, it typically subsides within three months after surgery has been completed.

Most cases of post-operative pain are caused by inflammation around the surgical site; however, other causes include infection or nerve damage caused by improper positioning during surgery (which can lead to loss of sensation in your breasts). Because there are several possible causes for this kind of pain.

Breast Augmentation Under Muscle Or Over

Breast augmentation pain and swelling: what’s normal and how to reduce it

Experiencing pain and swollen breasts after augmentation surgery is normal. Swelling is the body’s way of helping to heal tissue damage and protect the area.

On this page you’ll find out more about:

  • Breast augmentation and swelling
  • Breast augmentation and pain

Swelling after breast augmentation: what’s normal

How much swelling is normal after breast augmentation?

Your breasts will feel tight after surgery and swelling will peak around three to four days later. However, you may experience some swelling for up to three months after surgery and it can take up to six months for the implants to fully settle in place.

You can expect to have more swelling if:

  • you’ve had implants under your chest muscle, as this involves making an incision in the chest muscle, as well as the breast tissue and skin, so there’s more tissue that needs to heal
  • you have large implants—this could mean the breast and muscle tissue has been stretched
  • you smoke—smoking can slow down the healing process
  • you have certain pre-existing medical conditions, such as diabetes

How long does swelling last after breast augmentation surgery?

Most patients find that any swelling will have gone down by about three weeks after surgery. However, it’s normal to experience some swelling for up to three months. You can find out more about what to expect in recovery here.

Is it normal to have uneven swelling after breast augmentation surgery?

Some people experience uneven swelling in the chest after augmentation surgery and this is completely normal as it’s most likely due to the breasts healing at different rates. This will usually resolve itself within a few weeks.

However, uneven swelling could be a sign of something more serious, such as blood or fluid gathering at the wound in one of the breasts. If you’re concerned or experience significantly more pain or swelling in one side of the chest than the other, speak to your surgeon as soon as possible.

How can I reduce abdominal swelling after breast augmentation surgery?

After your operation, gravity can make the swelling in your breast tissue move down to the abdomen.

You can help reduce swelling in your abdomen by:

  • drinking plenty of water
  • walking around as soon as you feel able to do so
  • stopping or switching pain medication if your bloating is severe—narcotic painkillers can cause constipation, and it’s important you speak to your surgeon before making any changes to your pain medication
  • speaking to your surgeon about taking stool softeners if constipation is causing your stomach to bloat

Abdominal swelling is completely normal and should resolve itself within a few days. However, it’s also normal to experience bloating for a little longer as the effects of medication and lack of movement can slow digestion and cause constipation.

How can I make swelling go down after surgery?

  • Wear a supportive surgical bra as this gently compresses the breasts to reduce swelling
  • Speak to your surgeon about taking arnica supplements as this herb can be applied to the skin to treat swelling and bruising.
  • Being too active can actually aggravate the healing process, so only do gentle exercise for the first few weeks after your operation
  • If the top of your breasts still seems swollen around three months after surgery, this could be the implants themselves. It can take six months or more for implants to fully settle in place.

Breast augmentation and pain: what’s normal

Your chest will feel tight and sore after your breast augmentation. Your ribs may also feel sore below your breasts.

Your surgeon will help you manage the initial pain after your operation either by:

  • injecting local anaesthetic into the affected area
  • administering local anaesthetic via a pain pump—this slowly and continuously delivers pain medication to where the incision was made in your breasts

Your surgeon may also prescribe muscle relaxers and anti-inflammatory drugs, as well as narcotic pain medication.

After two to three days it’s likely you’ll be able to scale down your pain medication to over-the-counter painkillers, which you can take as and when required.

As well as the initial pain from surgery, it’s also common to feel the following in your breasts or nipples:

  • Shooting pains
  • Tingling pains
  • Burning sensations
  • Numbness

These sensations can last for six to 12 months after surgery. If you’re concerned about the type or amount of pain you’re experiencing at any point, speak to your surgeon.

Below is an overview of some of the types of pain you may experience and where and how soon after your operation you might feel it. You may experience this pain in either breast or both breasts.

Type of painWhere you might feel the painWhen you might feel the painPossible cause of the pain
SorenessAll over the breasts and chestIn the first 1–3 days after surgeryYour body recovering from surgery
Shooting painIn the nipplesWhere the incision was madeAll over the breastsIn the first 1–6 weeksMay last for the first 6 months or longerNerve pain caused by the nerves healing after being stretched
Stabbing painIn the nipplesWhere the incision was madeAll over the breastsIn the first 1–6 weeksMay last for the first 6 months or longerNerve pain caused by the nerves healing after being stretched
Aching painIn the back or shouldersIn the first 1–2 weeksHunching over to support your new breasts
Itching or burning sensationIn the nipplesWhere the incision was madeAll over the breastsIn the first 3–4 weeksMay last for the first 6 months or longerNerve pain caused by the nerves healing after being stretched
Tingling sensationFrom the side of the breasts to the nipplesIn the first 1–6 weeksMay last for the first 6 months or longerNerve pain caused by the nerves healing after being stretchedAir in the pocket where the implant was inserted

Not everyone will experience the above pain. If you have any concerns about the type or strength of the pain, or where you’re feeling it, contact your surgeon.

How long does the pain last after breast augmentation?

It’s normal to feel some pain in the first one to two weeks after having breast augmentation surgery. The pain will be most severe in the first few days and should gradually subside.

After six weeks, any pain or unusual sensations should have gone, although it’s fairly common for patients to experience shooting pains up to six months or more after surgery.

Some people also experience nerve pain, which can cause tingling, shooting pains, numbness or itching, particularly where the incision was made.

It can take over a year (or longer) for these sensations to disappear. This is because the nerves are often stretched during and after surgery and can take a long time to return to normal.

Is it normal to have back pain after breast augmentation?

Yes, you may experience pain in other areas of the body, such as the back and shoulders. Back and shoulder pain is most likely because you’ll naturally want to hunch over to support and protect your chest if it’s feeling tender. You should find this pain lessens as your body heals and adapts to your new breasts.

Is it normal to have a sharp pain where the incision was made?

Yes, it’s normal to have pain where the incision was made in one or both breasts, especially in the first few days after surgery. If the pain can’t be controlled with prescribed pain medication or you feel overwhelmed by it, speak to you surgeon immediately.

Is it normal to experience burning pain after a breast augmentation?

Yes, many people experience a burning sensation after having breast augmentation surgery. This happens because the nerves in the breast are stretched during surgery, and after surgery when the breasts are swollen.

The breasts are full of nerve endings so it’s extremely likely that the surgery will affect some of them. The burning sensation occurs when the nerves are regenerating and reconnecting with the area of the breast to which they normally supply feeling.

It can take up to six months or more for these shooting pains to resolve themselves.

How painful is breast augmentation under-the-muscle?

Having implants under the muscle tends to be more painful than over the muscles as your surgeon will need to make an incision in the muscle, as well as the breast tissue, to create the ‘pocket’ that your breast implant will fit inside.

You can expect to feel the most pain in the first one to three days after surgery. Your breasts and chest are likely to feel sore but you may also feel some stabbing or shooting pains. Your surgeon will prescribe you with pain medication to manage this.

You’re likely to experience less intense pain after under-the-muscle breast augmentation if you do the following:

  • Choose an experienced and highly qualified surgeon
  • Choose implants that are the right size for your frame
  • Follow your surgeon’s instructions for how to control the pain with medication

What if I find the pain unbearable?

Your surgeon will help you manage your pain so that you’re comfortable after surgery.

However, severe pain could be a sign of infection.

If you experience any of the following, contact your surgeon immediately:

  • The pain is severe and medication has no effect
  • Your breasts feel engorged or hot to the touch
  • You have a fever

If you’ve recently had breast augmentation surgery and have concerns about how much pain you’re feeling or the amount of swelling in your breasts, speak to your surgeon.

Problems with Breast Implants Under The Muscle

How to Manage Your Pain After Breast Augmentation

Pain and discomfort are common after breast augmentation surgery. Recovery from breast augmentation typically takes a little over a month. During that time, you may feel tired and sore and experience bruising. However, these symptoms will fade over time.

Sharp, shooting pains, and other discomforts in the breast are also common following surgery.1 The good news is that you can control most of your discomfort with the medication your doctor prescribes for you.

Doctor examining bandaged woman

First Week

Immediately after surgery, the nurse will bring you to a recovery room, where you will rest until anesthesia wears off. You will probably feel significant pain when you wake. Your doctor will help you manage any pain you experience with medication.

In the first week, you can expect to experience the following:

  • Lots of soreness
  • Tightness in your chest
  • Fatigue
  • Nausea
  • Swelling
  • Bruising

These symptoms will fade over time. Be sure to have a trusted friend or family member with you during recovery. This support is vital in the hospital and in the first few days at home.

After the first few days, your pain will likely decrease significantly. After about a week, your surgeon may clear you to return to everyday activities.

Avoid Strenuous Activities

In the first week, it is essential to avoid doing anything strenuous. In addition, refrain from lifting your hands over your head since this can cause pain and bleeding. Be sure to follow your doctor’s instructions on limitations and pain management.

First Month

After a few weeks, you may not notice any pain or discomfort. In addition, swelling and bruising usually diminish.

That said, everybody is different and recovers at different speeds. So, you may still see some bruising, especially if you had complications.

Full recovery typically takes four to six weeks. That means some people will fully recover at the one-month mark, while others may still need a couple of weeks to feel back to themselves.

Some things may impact your recovery:

  • The size of your implants: The larger your implants, the more pain you will have after your surgery. Lighter-weight implants are generally associated with less pain.1
  • The position of your implants: Implants placed underneath the pectoral (chest) muscles tend to hurt more post-surgery. This increased pain is because the tissue is experiencing more trauma. The less the tissues are traumatized, and the less bleeding there is the better your post-op pain level.
  • You’ve previously given birth: Some surgeons report that people who have given birth tend to have less pain.

Second Month

After about a month, most people will experience a full recovery. At this time, with your doctor’s approval, you will likely be able to resume your everyday activities without restrictions.

Your breasts will also have a more natural appearance and feel. You will likely have an appointment with your surgeon to assess your recovery.

Medical experts note that people who have been through childbirth compare post-augmentation to the breast engorgement that new parents experience after having a baby. Getting Bigger Breasts Without Implants With Autologous Augmentation


As with any surgery, breast augmentation may result in complications. These may include:

  • Excessive scarring
  • Hard breasts
  • Ruptured or folded implant
  • Nerve damage
  • Inability to breastfeed

When To Call the Doctor

Call your doctor right away if you notice any signs of a blood clot, excessive bleeding, or infection. These warning signs may include:

  • Redness
  • Warmth
  • Chest pain
  • Dizziness
  • Excessive tiredness
  • Fever
  • Chills
  • Headache
  • Nausea or vomiting

Recovery Tips

Most likely, your surgeon will prescribe medication to help you manage your pain. If you are not getting adequate relief from the prescribed medication, it may indicate that you need to see your surgeon. They may offer a device that automatically delivers numbing medication to the area for two to three days when you need it most.2

Here are some post-surgery tips for staying comfortable:

  • Rest when you feel tired.
  • Avoid lifting or straining for two to three weeks.
  • If your stomach is upset, eat bland foods.
  • Stay hydrated.
  • Take all prescribed or over-the-counter (OTC) medications according to your doctor’s instructions.
  • Ask your doctor if mild exercise, like walking, is OK.
  • Ask your doctor before doing stretching exercises (they may suggest some for you to do).
  • Ice your breasts for 10-20 minutes every couple of hours for the first few days.
  • Support your breasts with a surgical bra or bandage.

According to a scientific review, people who had their implants placed underneath the chest wall and then received Botox injections during or after the surgery experienced less pain.3 However, the review only looked at seven studies, and the authors state that the assessment of outcomes for this practice is inconsistent and needs more study.


Most people manage pain after breast augmentation surgery with medication, rest, and activity restriction. Usually, people fully recover after about a month, but it could take a little longer.

As with any surgery, breast augmentation holds certain risks. Complications may include nerve damage, scarring, infection, and blood clots. You should contact your doctor right away if you notice any warning signs of infection or bleeding. You can stay comfortable by taking your medication as prescribed, getting adequate rest, staying hydrated, icing, and supporting your breasts.

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