My muscles retracting tissue expander resulting in no mammary fold?Can deep massage release the muscle & open the pocket?(photo)

Question

3 weeks post-op, I had breast implant revision using tissue expanders. I feel a cord high in my chest wall to the bottom of my breast. Ive had 11 revisions & this cord always resulted in capsular contractor. Im desperate to do manual maneuver to drop it from my chest wall. My surgeon said the muscle is too tight & pulling expander up into chest wall. massage was recommended but is not working. can i push through the cord and muscle until the implant drops, is that possible?

Nirav B. Patel, MD, JD, FACS · Answer

I see that your question was posed in 2018 - I hope now, 3 years later, your issues have settled out, and by now you've exchanged back to permanent breast implants!
It would be good to know if those implants were placed subpectoral (underneath the pectoralis major muscle) or above (underneath the breast gland, subglandular, but still above the pec). Video can often be helpful in determining the degree to which you have animation deformity, where the pec can distort a subpectoral implant with flexion of the chest. Bottom line, though, there is no substitute for in-clinic, physical examination of your soft tissues, implants, and musculature by a qualified plastic surgeon.
Considering you have had eleven (11!) revisions, as you say, your breasts have held up remarkably well from the photographs that you sent. It is tough to tell where exactly this palpable cord is that you write about - I am guessing you were attempting to point it out in your second picture, showing the inner aspect of the (medial) Right breast?
The cord could be palpable edge of your breast implant, which suggests to me - as you are certainly thin and fit! - that you do not have enough soft tissue cover for your implants. Fat grafting can play a role in improving soft tissue cover, assuming your surgeon can find fat stores on your body from which he can harvest some fat!
When I read the word 'cord', I also wonder if you instead have postop Mondor's thrombophlebitis, in which you experience transient inflammation of a vein of the breast tissues, which usually resolves spontaneously and can be treated with warm compresses and NSAIDs for symptom relief. If it is true Mondor's, then this cord does not have a direct relationship with any capsular contracture issues you had developed in the past. It might be something correlated but not causal.
It's likely too late now, but I would only say to have faith in your plastic surgeon - assuming he or she is Board-Certified - and trust the healing process. If you develop significant, symptomatic (painful) capsular contracture again, you may have to change approaches or consider the option of living with no breast implants at all long-term for your own overall health.
Other options might also include wrapping the implant in cadaver skin (acellular dermal matrix) to help reduce the cap con risk, although it may also increase risk for postop issues such as seroma. Switching pockets (from subpectoral to subglandular, or vice-versa) may be a treatment option too, in combination with fat grafting to camouflage any visible irregularities such as rippling.
Good luck to you!!

My muscles retracting tissue expander resulting in no mammary fold?Can deep massage release the muscle & open the pocket?(photo)

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My muscles retracting tissue expander resulting in no mammary fold?Can deep massage release the muscle & open the pocket?(photo)

Answers (1)

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Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.