I had a bilat mastectomy w expanders 540cc. The expanders looked smushed but I was told that it is temporary and willl look better once the implants were in. I had the implants (550cc silicone textured) on Sept 5 and they look the same the expanders did, smushed and protruding out towards the underarms. The doctor said once I heal (3 months) I can have the impants changed to be on top of the muscle. Is this my only choice? After some research, I think the pockets were not made properly? Thanks
Are my Chest Muscles Too Tight for my Implants?
Doctor Answers 2
Does chest muscle tightness change the appearance of my implants?
The chest muscle is normally covering a portion of a tissue expander in the upper protion of the chest and in the lower portion there are a variety of methods to provide coverage of the expander. I use a material to create a sling or a hammock for the expander. This allows it to expand with hoepfully less discomfort. The expander shapes are varied. There are shaped implants now available through Sientra that I use for breast reconstruction that hopefully can provide improved results without the need for secondary procures such as fat grafting.
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Alloderm to optimize the muscle pocket for breast reconstruction
Without knowing more details it is hard to comment specifically, but an increasingly common approach to reconstruction with expanders uses a material called Alloderm to make an internal bra, so only the pectoral muscle is needed. This allows for much more control over pocket shape, quicker and less painful expansion, and a more stable implant pocket. before Alloderm, expansion using total muscle coverage would often lead to unnaturally flat, tight pockets. If you don't have Alloderm but are considering a revision I would recommend looking into that before going on top of the muscle.
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