Subpectoral Breast Implant Removal Technique
- Asked by AFEcoMom in Anderson, California
- 5 years ago
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?
Muscle function should not change
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 have a low risk of leaving you with muscular deformity or noticeable weakness, and therefore removal of implants placed during a well-performed operation should be low risk as well.
Naturally, the best way to assure you have the lowest risk possible of an untoward outcome is to be certain you see a surgeon Certified by The American Board of Plastic Surgeons, and ideally, that that surgeon also has significant training and experience in breast surgery.
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 that it has been disconnected from the sternum. The more the muscle is detached, the more the motion artifact will occur.
Often, especially when large implants are used, the muscle atrophies, or becomes thinner. However the nerve supply remains intact.
Patients should consider the destructive effect on the pectoral muscle before having large implants.
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 patients but it does not disintegrate. Although the larger the implant, the greater the thinning of the muscle. If the muscle has been extensively released, it can potentially be sutured back down to the chest wall, but this is unlikely to result in a durable repair.
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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.
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.
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.
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 place.
In my experience patients never complained about any muscle related issue after the implants were removed.
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.
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 muscle if the implants are removed. In addition, the size of the implant is critical because more muscle release must be done for bigger implants and larger implants will thin out the muscle more over time than more moderate sized implants.
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.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.