Do the pectoral muscles need to be stiched back down during explant with lift?

Question

I had 360 cc implants with a lift 6 mo ago. I regretting the implants and wish I had only gotten the lift. In 2 weeks, I am having explant and a revision of the lift. I have muscle animation deformity. My surgeon does not do anything to the pec muscle that was cut as part of the explant. I have read that other surgeons stitch the pec muscle back down. How necessary is it to fix the cut pectoral muscle and is it likely that I'll need another revision if the muscle is not reattached?

Jed H. Horowitz, MD, FACS · Answer

hello kate91169  Chest wall (rib and breast bone) and shoulder / back asymmetries that exist before will not be corrected from the surgery and will affect the breast shape and position. Neopectoral pocket: This is sometimes used as a technique to   provide a stronger better 
space.  In this case, the implant is removed   and the capsule is 
dissected from the muscle, creating a new or neo   pocket on top of the 
old capsule. #pectoral #stitches

Kenneth Hughes, MD · Answer

The animation deformity is the result of the placement of the implant in the submuscular position.   Without the implant, the ability of the muscle to generate that defect is altered.

Robert Whitfield, MD · Answer

You typically cannot get the chest muscle back to a normal position.  I have done many of these types of cases and it is not possible to get the chest muscle back to its normal position.

Tom J. Pousti, MD · Answer

Practices will vary.  In my practice, I individualize the breast implant removal procedure depending on the patient's physical examination, concerns, and goals. For example, if the patient does have significant (bothersome) flexion deformity, then restoration of normal pectorals major muscle attachment to the chest wall makes sense.  However, in most cases of breast implant removal surgery, I have not found the need or benefit of  re attachment of the pectoralis muscle. Best wishes for an outcome that you will be very pleased with.

Kelly Killeen, MD, FACS · Answer

I always repair the pectoralis muscle when I remove a submuscular implant.  When your implant is removed, the stretched, partially detached muscle can jump and look abnormal even with the implant out.  I have not seen that this improves with time.  This is especially true if you already have a significant muscle flex deformity.  I have found that repairing the muscle at the time of removal prevents this, and the repair holds up beautifully long term.  You should also consider internal lift and fat grafting at the time of your removal to help repair the stretching and thinning that occur with an implant.  Good luck!

Do the pectoral muscles need to be stiched back down during explant with lift?

Answers (5)