I am explanting. Is it important to explant en bloc and does the muscle have to be sewn back?

hello niptuck123 The removal of breast implants that have been placed either for cosmetic or reconstructive purposes is a surgical operation.  Breast implant removal may be performed as a single surgical procedure or combined with additional procedures, as follows:

Simple breast implant removal, without removal of capsule tissue around implant
Removal of tissue surrounding the breast implant (capsulectomy)
Removal of escaped silicone gel in breast tissue (extracapsular, outside of capsule layer) from silicone gel-filled implants (breast biopsy)
Breast lift (mastopexy following breast implant and/or capsule removal) #options #enbloc 

It is advised to have the capsules removed along with the implants under certain circumstances.  Some include if the capsule is thickened, if there is contracture, or if there is rupture of the implant.  Your surgeon can advise what is best for you.  Muscles can be reattached if needed.

Hi and thanks for your questions.  If the capsule is not causing you discomfort (thickened capsule, capsular contracture, calcification, ruptured silicone implant), then there is usually no need to remove it.  If the above are occurring, then en bloc removal is a good option. I also agree with several of the other RS surgeons answering this question - if the implant was below the muscle, and the muscle was completely released, a repair should be attempted but may not be successful.  Discuss your particular situation at length with your surgeon.To assure that you get the result that you are looking for, I would recommend that you search for an ABPS board certified plastic surgeon who is also a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons.  Membership in these societies demonstrate a surgeons commitment to safety and specialization in aesthetic and cosmetic surgery.  Assure that they have multiple before and after photos of results that you like so that you can have an informed discussion about your breast revision and possible results.

Best wishes,
Dr. Brown