title: Strength performance of the pectoralis major muscle after subpectoral breast augmentation surgery.
abstract: BACKGROUND
  Although subpectoral placement of breast implants is a commonly used technique in breast augmentation surgery, the ultimate effects of this procedure on the strength or function of the pectoralis major muscle (PMM) remain undetermined.
  
  
  OBJECTIVE
  In this study, we investigated whether subpectoral placement of mammary implants negatively affects the strength performance (SP) of the PMM.
  
  
  METHODS
  Twenty women underwent isokinetic testing with the Biodex 3 System (Biodex Medical Systems, Inc, Shirley, NY) before surgery and 2 and 6 weeks after subpectoral placement of breast implants. Nine patients returned for long-term testing. To isolate the PMM, we tested two motions: internal rotation and extension/adduction. The results were evaluated in two ways. We compared postoperative SP to baseline (preoperative) SP using paired Student t tests. P values of less than 0.05 were considered statistically significant. SP was also evaluated with the Biodex 3 System Standards, which consider a postoperative SP of less than 75% of baseline significantly impaired and one more than 75% to be within normal limits.
  
  
  RESULTS
  Paired comparisons indicated statistically significant reductions in SP 2 weeks after surgery, followed by increases in SP by 6 weeks. When applying the Biodex 3 System Standards, we found that in both internal rotation and extension/adduction, nearly half of the patients had recovered to 75% of baseline SP 2 weeks after surgery and that more than three- quarters of the patients were fully recovered 6 weeks after surgery. Long-term follow-up in 9 patients revealed retention of SP or further improvement.
  
  
  CONCLUSIONS
  Subpectoral placement of mammary implants did not produce statistically significant long-term loss of upper-extremity SP. It appears that no permanent loss of strength of the PMM results from subpectoral placement of breast implants. (Aesthetic Surg J 2003;23:92-97.).
authors.affiliation: St. Joseph's Hospital, Phoenix, AZ, USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Beals
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Golden
authors.forename: Michael
authors.initials: M
authors.lastname: Basten
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Kelly