When the breast implants are placed under the muscle a little part of its distal most attachment to the sternum is cut to avoid the implant from displacing too much whe the muscle is contracted. The size of this cut depends on each surgeon, size of the implant and several other technical factors. Sometimes during the enbloc procedure the muscle can be injured as well depending on the degree of adhesion between the capsule and the muscle. Although the idea of these muscle injuries is very stressful to most patients, the procedure to repair the muscle is actually not very difficult (unless there’s a complete detachment) and Dr. Urzola systematically repairs the muscle if it is injured. It is very important that the patients follow directions and avoid any sort of physical activity that stresses the muscle after a repair, since it would be very easy for it to break potentially producing bleeding. In these cases surgery will be required to control the bleeding and repair the muscle once again.