in my 32 years of practice, I have a lot of patients for, revision breast surgery, referred to me. It's not an easy procedure to retrieve the muscle that has retracted. This is called "window shading". In these cases I also use acellular dermal matrix (ADM)grafts to bridge the gap between a retracted muscle and the attachments along the breast bone and lower ribs. the success of the results vary
I will parrot some of my colleagues below and while I have not examined you personally, A breast lift with internal sutures only may give you some elevation of your breast tissue, but will do nothing about nipple position or excess tissue below the fold of your breast. I would recommend a frank discussion with your PS about the expected results and possibly a second consult to be sure you are getting sound advice.
I hope this helps
Let me first comment on the animation deformity of the chest muscle. This is something that is most commonly seen when implants are inside. The pec muscle should return to nearly its normal arrangement after removal. Repair of the muscle to try and get it to lay or move in a different way would have a questionable outcome.
An "internal" breast lift may slightly lift the sagging tissues but it will do very little for nipple position or the breast fold. Your expectations are the most important factor here, and this needs to be discussed in detail with your surgeon.
My advice as always would be to seek a few opinions.
So you are going to have your muscle sewn back down to the chest wall which is invasive and requires an incision and dissection and suturing, but you've opted for a breast suspension technique for your lift? I can honestly say that I saw these techniques done during my fellowship by very talented surgeons that were performing the studies for the device companies (I even assisted in one during a live surgery demonstration at a major breast symposium). I was less than impressed and found the systems to lack power and be able to achieve a more beautiful result than a formal breast lift. There may be other options for you that would result in a better shape and outcome. It's hard to give you advice without examining you though, so consult with several board certified plastic surgeons and chose the one that can deliver you the best result.
Thanks for your question. Without a photo it is hard to give advice on the outcome. Not knowing your nipple position for example makes it hard to say how much of a lift you might need and what technique would be ideal. There might not be a lot to change with regard to the position of the muscle. When it contracts it will always do so toward the arm pit because of its connections. The amount of breast tissue is important in doing an internal lift as well as the quality of the breast tissue. This would need to be determined with a consult and exam. Best of Luck!
I don't think that I can really add anything to my colleagues comments below except to say that I am not sure that sutures alone will deliver the results that you want. Make an appointment with your surgeon to be assessed in person and have a frank discussion about your options and expectations. Best, Dr. Nazarian