Does the muscle have to be repaired after breast implant removal?

Question

Hello! I am thinking about having my breast implants removed and not getting new ones. I would do this under local in the office leaving capsules in. The original implants were smooth saline placed under the muscle. Would they come out the same way and if so , does it damage my muscle ? Does the muscle have to get repaired? Thanks in advance!

Joshua Cooper, MD, FACS · Answer

When breast implants are removed, the capsule (scar tissue surrounding the implant) may certainly be left in place. The only time removing the capsule would be recommended is if the capsule is thickened.  Patients who have a capsular contracture for example would want the capsule to be removed. The muscle is left alone when removing implants and does not need to be repaired. Thanks for sharing!

Gary M. Horndeski, MD · Answer

Women who undergo explant alone are dissatisfied with the excess hanging skin and require a lift later.  It is best to undergo explant and lift simultaneously using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Amia33, in most cases plastic surgeon will use previous incision in order to avoid further scars. Most plastic surgeons will try to remove capsule if it is thick. In case the capsule is thin, it can be left in place and no muscle reattachment is necessary. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question.  In general most patients with thin capsules can have their implants removed through their previous incision and not require any muscle work.  A compression garment should be worn to help minimize the risk of fluid collection while your tissues heal, however.  Hope this helps.

Christine Blaine, MD, FACS · Answer

Hi and thank you for your question.  If you are removing your implants and do not wish to replace them you do not necessarily need to remove the breast capsule, unless the capsule is thickened or calcified as in the case of capsular contractures.  There should not be a need to ‘repair’ the muscle either, nor should there be any damage to the muscle upon implant removal.  I hope that this helps!!

Aric Aghayan, MD · Answer

Dear Amia33,Generally it is not necessary to do any work to the muscle itself when only removing implants. Typically the same incision that was used to place them is used and removal is much easier than the initial placement. Good luck.

Tom J. Pousti, MD · Answer

No, in most cases "muscle repair" is not necessary, with breast implant removal surgery. There are however exceptions;  there are cases where additional "internal work" helps achieve a better aesthetic outcome. Best to communicate concerns/questions directly with your plastic surgeon. Best wishes.

Susan Kolb, MD - Account Suspended · Answer

The peer reviewed literature recommend total capsulectomy in order to avoid later complications with seroma, infection, and problems with cancer detection.  This is more important for textured implants, silicone implants that are leaking, and cases where drains are not used.  Muscle repair is usually done after capsulectomy if the pectoralis muscle was cut by the implanting surgeon if possible (both sides of the muscle need to be seen and the gap needs not to be excessive for repair to work), in order to correct deformity.

Does the muscle have to be repaired after breast implant removal?

Answers (8)

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