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Possible to Have over the Muscle Breast Augmentation After Mastectomy?

asked 2 years ago by ER girl in NM
Latest answer by Sam Speron, MD
Question viewed 1,248 times
Tags: breasts, expander, mastectomy, over muscle, pain

I am post bilateral mastectomy, after 10 years, I finally have expanders. They were placed in Nov. I am having pain 6/10 on one breast area and to the shoulder and arm..

I am afraid that after the implants I will continue having pain. Can the Breast implants be put over the muscle? Or is there an artificial muscle that can be used?

My concern is how to distinguish breast pain vs cardiac pain in the future. Implant schedule is in April.

14 answers to Possible to Have over the Muscle Breast Augmentation After Mastectomy?

Breast and Chest pain with under the muscle tissue expander reconstruction following mastectomy

It is quite common to have pain during the expansion process. This seems to be particularly worse about 4-6 hours after each expansion rather than immediately with injection. Typically surgeons may over expand and then place a final implant that is smaller than your fully expanded size which should provide you with some relief. The rate of complications and unacceptable appearance wtih over the muscle placement ( exposure, extrusion, capsular contracture, visible rippling, etc) generally... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Breast pain during reconstruction should be evaluated, but may not improve on top of your muscle

Hi there- Only your surgeon will have the understanding of what has occurred to date necessary to explain what might be causing your pain, and what options you have for improving it. I would not, however, assume that your pain is due to the expanders being under the muscle, or that putting your implants on top of the muscle will make this better. Talk to your surgeon about your situation and see what the two of you can come up with.

Armando Soto, MD
Orlando Plastic Surgeon

Implants after mastectomy

If you have had tissue expanders placed, you most definitely had them placed under the muscle and possibly even with Alloderm along the lower border. This is done so that there is adequate soft tissue protection over the implant when the permanent implant is placed.

Steven Wallach, MD
Manhattan Plastic Surgeon

Your discomfort should be better after switching to breast implants

It is pretty common to be uncomfortable while the expansion process is ongoing. When you change to implants they are much softer and move with the body better than the expanders. I agree that putting the final implants above the muscle is probably not a good idea unless you have very thick skin flaps. You need to have adequate coverage over the implants or they can be felt and in some cases extrude. Discuss your concerns with your plastic surgeon, they should be able to allay your... more

Scott Tucker, MD
Winston Salem Plastic Surgeon

Implant placement after mastectomy

In most cases, it is best to have the implants below the muscle after mastectomy. During the mastectomy, all of the breast tissue was removed, which leaves only skin. It is not safe to only have a very think skin layer between the outside environment and the implant. If your expanders are in place under your muscle and you are still undergoing expansion prior to the final implants, you may have some discomfort during the expansion process. It is best to discuss this situation with your... more

David Shafer, MD
New York Plastic Surgeon

www.ShaferPlasticSurgery.com

Implants always under the muscle after mastectomy

Sorry to hear about your ordeal with the expanders. To clarify some terminology, implants after mastectomy is reconstruction, implants to make breasts larger is augmentation. When the breast tissue is removed, there isn't much of a layer left to cover and support the implants; that is why they have to go under the muscle. The tricky part is that the pectoral muscle only covers the upper 2/3, so if your expanders were placed usung a total muscle cover technique then additional muscles were... more

Richard Baxter, MD
Seattle Plastic Surgeon

Breast reconstruction and implant placement

Hi, Thank you for your question. Expander pain and cardiac pain are very different. However, every patient is different and therefore experience different symptoms. It should not be assumed that the pain is from your expander, althought it is very common to experience this pain while your tissue is expanding. I would definitely seek medical attention just to be safe. Heart issues are often undiagnosed in women. Providing that the pain is from your expanders, the pain does subside in most... more

Sam Speron, MD
Chicago Plastic Surgeon

Breast Reconstruction with Implants OVER the muscle after Under the Muscle Expansion

As a 10 year survivor, it is safe to say the breast cancer is behind you. However, to get good looking reconstructed breasts you must carefully navigate the limitations dictated by your mastectomies and remaining tissue characteristics. The reason why the vast majority of implants in Breast Augmentation are placed UNDER the muscle is because all implants ripple and their shells are palpable. To get an attractive result, implants MUST be covered with as much tissue buffer as possible. Good... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Possible to have over the muscle Breast Augmentation after mastectomy.

It is possible but not advisable. I would need to see photos and than can give a more specific response. Go see 3 boarded plastic surgeons in your area. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Your breast pain can be because of capsular contracture

You should not have pain after reconstruction unless there is capsular contracture. Please get a consultation with your plastic surgeon. Post mastecomy, all implants are placed under the muscle to provide protection and coverage to the implants.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Breast reconstruction with tissue expansion and implants

Many patients find their tissue expanders uncomfortable and feel much better when the final implants are placed. This is probably due to the expanders being stiffer than the implants and the fact that the expansion process is occurring. I would expect that you will feel much better after your expanders are replaced.

Susan E. Downey, MD
Los Angeles Plastic Surgeon

Breast reconstrucion implants need to be under the muscle

Because all you have is skin on muscle after a mastectomy, it is necessary to put a reconstruction implant under the muscle to get as much coverage as possible. Make sure your plastic surgeon knows your concerns and as they know you best, maybe they can figure out why you are having the discomfort.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast implant placement after mastectomy

Your breast implants really need to stay under the muscle. During a mastectomy, all of your breast tissue is removed, which leaves only the skin above the muscle. Placing an implant in this location increases the risk of implant extrusion and infection, and will also be less attractive cosmetically. Breast pain and cardiac pain are different -- cardiac pain is usually more of a "crushing" sensation. That being said, everyone experiences pain differently, and cardiac problems... more

Nina S. Naidu, MD
New York Plastic Surgeon

Breast reconstruction pain

Expanders may cause pain because of the use of pressure to perform the expansion process. It is easy to deflate the expander to relieve the pressure to see if this is contributing to the pain. You did not mention if you had radiation to the breast as this can also cause more pain, discomfort and tightness. Also, if the muscle has not been release adequately this might cause pain as the muscle is forceably stretched. It is generally not advisable to place the implants over the muscle after... more