Is muscle repair and reattachment at explant, why or why not?

Question

seeking removal of of under muscle saline implants. x 16 years. i feel stupid for not having realized that my muscle had been cut/released from my ribs during the implant initial operation. it sounds so obvious now. i'm told it needs to be reattached anda big reason for the high total cost. what do you understand about muscle repair? is it needed? how does reattachment promote health and function over the long term? A)explant only under local v B) explant +muscle repair under general. why

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It is completely understandable to have concerns or questions regarding the long-term effects of your breast augmentation, especially if you were not fully aware of the muscle manipulation that occurred during the original surgery. In the attached video I explain muscle repair and reattachment and answer your questions/concerns. Consulting with a highly skilled plastic surgeon who understands your history and unique anatomy is crucial in deciding the best approach for your explant surgery. They can help assess the need for muscle repair and advise on what would provide the best outcome both functionally and aesthetically.

Daniel Barrett, MD · Answer

Dear mm621,
generally speaking, implant removal surgery doesn't include muscle reattachment. In most cases, saline implants can be removed under local anesthesia. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

The muscle laterally is attached to the fifth and sixth ribs. Often times with the dual plane technique or with submuscular implants, the muscle is cut. Once the muscle is cut, it retracts and cannot be stretched out again. The muscle is atrophied and lost. You can reattach it but it will not be functional because of atrophy from lack of use. I do not recommend repairing the muscle. However, I recommend explantation and lift 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 (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Many muscles are actually not or cannot be repaired since they have shrank away from the sternum or have already healed back to the sternum.  I find in most women that "muscle repair" is usually not needed nor a concern.

Mats Hagstrom, MD (license on probation) · Answer

It’s not possible to repair or reattach the pectoralis muscle in any useful way during implant removal. It sounds to me like someone is trying to take you for a financial ride.
The decisions involved with explantation are generally if implants have capsular contraction should a capsulectomy be performed, and or should drains be placed for postoperative fluid management. 
I suggest getting a few more consultations.
Best,
Mats Hagstrom, MD

Is muscle repair and reattachment at explant, why or why not?

Answers (5)