Depending on patient's anatomy and preferences an implant is inserted into an incision through the armpit (the transaxillary approach), around the areolar (the areola/periareolar approach) or under the crease in the breast (the inframammary approach). The implant is placed either behind the large chest muscle (post-pectoral) or between the breast tissue and the chest muscle (pre-pectoral). It is not placed within the breast tissue. Incisions are closed using fine sutures that leave little visible scarring. The procedure is normally performed under general anaesthetic in a hospital and takes about 1½ hours. Breast augmentation can be painful, especially when the implants are placed behind the muscle.