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Subpectoral Breast Implant Removal Technique

asked 3 years ago by AFEcoMom in Anderson, California
Latest answer by Ronald J. Edelson, MD
Question viewed 19,879 times
Tags: above muscle, incision, subpectoral

I have read questions regarding breast augmentation and if you are unhappy with the results, you can always take them out. Of course, doctors warn the more your skin stretched the less youll look like your original self, but that they CAN return to normal. I however am wondering, if you get implants under the muscle and somehow or someday decided to remove them without replacement, what happens to the muscle that was cut to fit the implant underneath? Can that be fixed, or does it heal itself? Does the muscle disintegrate?

21 answers to Subpectoral Breast Implant Removal Technique

Subpectoral implant removal and Pectoralis muscle

The answer to your question depends a lot on how the original augmentation was performed and what was done with the muscle at that time. Altthough we all use the term submuscular or subpectoral augmentation, in the truth the operations are not all exactly the same. There can be varying degrees of muscle dissection or release depending on surgeons preference, size of implant, and specific anatomic muscle variations in each patient. In general there is some thinning of the muscle in all... more

Braden Stridde, MD
Federal Way Plastic Surgeon

Muscle function should not change

Hi- I agree that larger implants and greater degrees of muscle dissection from the sternum increase the risk of muscular deformity with contraction, but this is something that generally is seen with the implants in place. If this occurred while your implants were in place, then you are likely to have the problem after they are removed; if you did not have the problem with the implants in, you are unlikely to have it after removal- in other words, a well-performed breast augmentation should... more

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Pectoralis muscle after submuscular breast augmentation

In submuscular breast augmentation, the implant is placed under the pectoralis major muscle. This muscle begins with attachments along the sternum and on your ribs and then it fans across your chest, inserting onto the humerus bone. If you flex your arms like you are doing a fly, you can feel the edge of the muscle near your armpit. The lower, outer half of the implant is covered by the muscle, not the whole implant. In most cases, the surgeon will release the muscle... more

Tracy Pfeifer, MD
Manhattan Plastic Surgeon

Subpectoral breast augmentation

This is an excellent question, what happens to the pectoral muscle after breast augmentation What was done at the initial surgery will determine what happens after the surgery. If large implants were placed, the muscle is often separated from the breast bone (sternum), in order to produce more cleavage. Those fibers will never reattach, even if they are sewn back on with heavy sutures. When the pectoral muscle is used, the muscle can "jump"; it is contracting but doesn't know... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

Muscle Repairs well After Implant Removal

The pectoralis (chest) muscle does repair itself well after implant removal, and does not require suturing or repair by your surgeon.

Paul C. Zwiebel, MD
Denver Plastic Surgeon

What happens to the Pectoralis muscle after Submuscular Breast Implant removal?

The pectoralis muscle is split in the axis of its fibers to remove submuscular breast implants. The muscle will heal with or with out repair using this technique.

Fredrick A. Valauri, MD
New York Plastic Surgeon

www.drvalauri.com

Breast implant removal

Once the implant is removed, the implant pocket collapses on itself. Gradually scar tissue is formed within the pocket sticking the muscle back over the ribs. You do not have to do anything with the released muscle. It stays in place as it heals.

Siamak Agha, MD, PhD
Orange County Plastic Surgeon

Muscle changes after Implant Removal

Muscles are released to create a space into which the implant is placed. How and how much of the muscle is release is very variable. However, regardless of the situation, once the implant is removed from submuscular space (if it was placed under the muscle), there is no change in the way the muscle functions and feels. If you were able to function with implants in, you will be able to continue after the implants come out. The muscle will simply heal in it's... more

Martin Jugenburg, MD
Toronto Plastic Surgeon

Effect on the Pectoralis Chest Muscle after removal of Under the muscle Breast Implants

In a well done under the muscle breast augmentation only the pectoralis muscle origins along the inferior aspect of the breast are detached but the origins from the central bone (sternum) are left intact. Scar tissue then heals and welds all the tissues together. At the time of sub-pectoral breast implant removal, the implants are removed without affecting the muscles in any way. The scar tissue which formed after the original operation is not disrupted and the muscles are not... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Leave the breast muscle alone!

Depending on how the implants were placed, it is extremely likely that the muscle has contracted and changed shape according to the type of cutting that the doctor performed to put the implants behind the muscle. There is no good way to correct this. Just forget about it and enjoy your body without the implants.

Robert M. Freund, MD
New York Plastic Surgeon

It depends on how the initial surgery is performed

It is generally best to place implants in the subpectoral position because of better mammographic visualization of the breasts when compared to subglandular placement. They also look more natural and are less easy to feel because they are covered by more tissue. Finally, the capsular contracture rates seem to be less under the muscle. That being said, there are many ways to create the pocket and how the muscle is handled will affect the answer to your question regarding the state of the... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

This is a great question that deserves to be discussed at length with an experienced plastic surgeon

Thank you for your great question? First allow me to say that it is imperative that you see a board certified plastic surgeon that is experienced in breast surgery. Your physical examination is essential in estimating what will happen to the pectoralis muscle and skin following implant removal. Other key factors are the size of the implants that were used, the surgical technique employed by the plastic surgeon, how long the breast implants have implanted, and any complications from the... more

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Implant removal

If the implants were placed in the sub pectoral space, removal of the implants should not result in any significant problem. This does depend to some degree on what work was done to the muscle at the time of the original surgery, such as extensive detachment of the muscle from the sternum. However, for the most part the muscle will function normally with minimal if any distortion.

Ronald J. Edelson, MD
San Diego Plastic Surgeon

Removing your implants

Occasionally, I see patients who just want the implants removed because they don't want the implants "to be a part of them" anymore. Make sure you think about this and that this is the right thing for you. It's difficult to say if you need a lift after removal -- no one will know exactly what your breasts will look like after the implants are removed until it is done. Talk to your surgeon and get good advice.

Tom J. Pousti, MD
San Diego Plastic Surgeon

Muscleafter implant removal

The muscle that was cut along the inferomedial aspect of the chest remaiins that way. Since it was stretched, it flattens out on the rib cage.

Steven Wallach, MD
Manhattan Plastic Surgeon

The muscle has already healed

After sub-muscular breast augmentation the part of the muscle which is separated or cut in order to allow for placement of the implant heals above the scar capsule. After removal of the implant the muscle continues to be in the tissue above the scar capsule and has already healed and therefore doesn't cause a problem. You should be aware that in some cases removal of the implant may cause some drooping of the tissue. There are some great Q&A on this forum about... more

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon

Muscle condition after explantation of subpectoral implants

There is no universal method of placing implants under the pectoralis muscle. Usually the lower portion of the muscle that is attached to the parasternal bone is cut but this is not always complete. Some doctors leave some muscle attached to prevent the separation your are alluding to. Other may not detach it at all if they are doing a blind and blunt transaxillary apporach. Having said that, when explanting subpectoral implants, a surgeon should be prepared to reattach the muscle if it is... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

The muscle thins a little with breast implants underneath it

Hello, The pectoral muscles do change a bit with implants underneath them. As long as the implants are not really large the changes are usually mild. If implants are later removed, the muscle comes to rest against the chest without much of a problem in most cases. There is always variability depending upon implant types used and local tissue reactions particularly for old silicone gel implants.

John P. Di Saia, MD
Orange Plastic Surgeon

The muscle edge is attached to the breast and covered by the capsule

When we examined the implant pocket for submuscular augmentation we find that the pocket has already healed and that the muscle is covered by the capsule. Partial or complete removal of the capsule could be needed but this will not affect the muscle.

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

Will not notice much after implant removal

If you get to the point or age where you would just like to have your implants removed, the shape of your breasts with not be significantly distorted other than normal aging. That of course also depends on your pre-augmentation breast size and how large your implants are. These few points of discussion with your surgeon can give you some idea of how your breasts will appear after explantation. Usually you will just return to your pre-augmentation appearance. The only thing that can't be... more

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Very little

Dear Mom, That is very well thought out question. By the time you would consider removing your implants, you would know what functional deficits you had incurred from the cutting of your pectoral muscles. From a cosmetic point of view, you probably would not see any difference. If you are a bodybuilder or professional/amateur athlete who relies on the use of their pectoral muscles to compete you should have your implants placed above the muscle. Good luck!