Approximately 25 years ago, drawing upon experience gained from post-mastectomy breast reconstruction patients, plastic surgeons began placing the implants behind the pectoralis muscles of the chest for cosmetic breast augmentation.  The technique gained popularity, and is now the most commonly used placement for implants, largely because of two advantages:  1) post augmentation mammograms are more reliable, because less breast tissue is obscured when the implant is positioned behind the muscle; and 2) placement behind the muscle lowers the incidence of capsular contracture, a post-surgical hardening of the tissue around the implant, which can make the breast feel undersirably firm.

Botox, which has been widely used for several years in plastic surgery to minimize deep lines and wrinkles, is now being used to minimize scars.  In a study from the Mayo Clinic, plastic surgeons injected Botox into the skin of the foreheads and upper cheeks of patients following excision and closure of skin lesion sites.  As expected, Botox minimized general movement of the area.  Since the movement of the skin surrounding the surgical site often adversely affects the healing process, they found that the Botox-injected wound sites, which had minimal motion, produced superior scars.