Likelihood of muscle and/or chest wall damage with en bloc explant?

Unfortunately, you have not provided photographs or told us your bra size.  En bloc resection can de-vascularize the remaining breast tissue.  Many women who undergo explantation alone are dissatisfied with the excess hanging skin and require a lift.  It is best to do both at the same time.  The technique I recommend is explantation 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.

Unlikely any significant damage.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

If you see an experienced board certified plastic surgeon the risk of damage to the chest wall during an en bloc capsulectomy would be very low.  I encourage you to discuss your concerns with your surgeon and ask about his/her experience with this particular procedure.  You can find board certified plastic surgeons near you by visiting the ASPS website.