I had a bilat mastectomy w expanders 540cc. The expanders looked smushed but I was told that it is temporary and willl look better once the implants were in. I had the implants (550cc silicone textured) on Sept 5 and they look the same the expanders did, smushed and protruding out towards the underarms. The doctor said once I heal (3 months) I can have the impants changed to be on top of the muscle. Is this my only choice? After some research, I think the pockets were not made properly? Thanks
Are my Chest Muscles Too Tight for my Implants?
Doctor Answers 2
Does chest muscle tightness change the appearance of my implants?
The chest muscle is normally covering a portion of a tissue expander in the upper protion of the chest and in the lower portion there are a variety of methods to provide coverage of the expander. I use a material to create a sling or a hammock for the expander. This allows it to expand with hoepfully less discomfort. The expander shapes are varied. There are shaped implants now available through Sientra that I use for breast reconstruction that hopefully can provide improved results without the need for secondary procures such as fat grafting.
Alloderm to optimize the muscle pocket for breast reconstruction
Without knowing more details it is hard to comment specifically, but an increasingly common approach to reconstruction with expanders uses a material called Alloderm to make an internal bra, so only the pectoral muscle is needed. This allows for much more control over pocket shape, quicker and less painful expansion, and a more stable implant pocket. before Alloderm, expansion using total muscle coverage would often lead to unnaturally flat, tight pockets. If you don't have Alloderm but are considering a revision I would recommend looking into that before going on top of the muscle.